Abstract:
Objective
To compare the clinical efficacy of laparoscopic radical surgery with different guided anatomical approaches in the treatment of early rectal cancer.
Methods
A retrospective analysis was conducted on 101 patients with early rectal cancer who underwent surgical treatment and follow-up at the hospital from January 2021 to December 2023. The patients underwent laparoscopic radical rectal cancer surgery. According to the different anatomical approaches chosen for surgery, 53 patients who underwent laparoscopic rectal cancer radical surgery under autonomous nerve guidance were included in the nerve guided group, while the remaining 48 patients who underwent laparoscopic rectal cancer radical surgery under vascular guidance were included in the vascular guided group. SPSS 25.0 statistical software was used to analyze the data. Perioperative related indicators and gastrointestinal hormone indicators were expressed as (![]()
), and independent sample t tests were performed. The occurrence of urinary dysfunction was analyzed using χ2 test, and the grading of urinary function was performed using a Rank Sum test. P<0.05 indicated a statistical significant difference.
Results
The intraoperative bleeding volume in the nerve guided group was less than that in the vascular guided group, and the first exhaust time was shorter than that in the vascular guided group,with statistical significant differences (P<0.05). There was no statistical significant difference in surgical time,lymph node dissection count, and hospital stay between the two groups (P>0.05). On the 2nd day after surgery,the serum GAS and MOT levels in both groups decreased compared to before surgery, but the serum GAS and MOT levels in the nerve guided group were higher than those in the vascular guided group, with statistical significant differences (P<0.05). At 7 days after surgery, the urinary function grading of the nerve guided group was better than that of the vascular guided group, and the incidence of postoperative urinary dysfunction (18.7%)was lower than that of the vascular guided group (39.6%), with statistical significant differences (P<0.05).
Conclusion
Both autonomous nerve guided and vascular guided laparoscopic radical surgery have good clinical effects in the treatment of early rectal cancer. However, the former has less intraoperative bleeding,faster postoperative intestinal function recovery, and can reduce postoperative urinary dysfunction.
Key words:
Rectal Neoplasms,
Laparoscopes,
Mesorectal Excision,
Autonomic Nervous System,
Urination Disorders
Junkang Zhao, Qianjin Zhang, Huijie Zhuang. Clinical comparison of laparoscopic radical surgery with different guided anatomical approaches for the treatment of early rectal cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(04): 401-404.