探讨腹腔镜下全直肠系膜切除术（TME）联合经肛门内括约肌间切除术（ISR）对低位直肠癌的治疗效果及肛门控便功能的影响。

选取宜昌市第二人民医院手术治疗的低位直肠癌患者159例，收集时间为2014年1月至2017年1月，根据手术方式不同分为腹腔镜组69例（腹腔镜下TME＋ISR手术）、开腹组90例（采用传统开腹手术实施TME＋ISR手术治疗），对比两组的手术相关指标及术后肛门控便功能。

腹腔镜组的手术时间、清扫淋巴结数目与开腹组比较差异均无统计学意义（t=1.209，1.585；P<0.05）；腹腔镜组患者的手术出血量、肛门排气时间及住院时间均小于开腹组，差异均有统计学意义（t=13.834，5.930，6.556；P<0.05）；腹腔镜组术后肛门控便功能显著的优于开腹组，差异具有统计学意义（Z=-2.183，P=0.029）；术前，两组患者的肛管收缩压（t=1.381，P=0.397）、肛管最大收缩时间（t=1.047，P=0.297）及肛管静息压（t=0.483，P=0.495）差异均无统计学意义；术后3个月，腹腔镜组患者的肛管收缩压、肛管最大收缩时间及肛管静息压显著高于开腹组，差异均有统计学意义（t=3.571，5.188，3.448；P<0.05）。腹腔镜组患者手术并发症率为7.25%，显著低于开腹组患者的17.78%（χ²=4.003，P=0.045）。

腹腔镜下TME联合ISR对低位直肠癌的治疗效果良好，并且具有创伤小、术后患者肛门功能恢复好的优点。

To investigate the effect of laparoscopic total mesorectal excision (TME) combined with transanal internal sphincterectomy (ISR) on the treatment of low rectal cancer and the effect of anal control function.

159 patients with low rectal cancer who were treated by Yichang Second People′s Hospital were selected. The collection time was from January 2014 to January 2017. According to the different operative methods, sixty-nine cases were divided into laparoscopic group (laparoscopic TME+ ISR operation) and ninety cases of laparotomy group (TME+ ISR operation was performed by traditional laparotomy), comparing the indicators related to the operation and operation in the two groups after anal function.

The operative time and the number of dissection nodes in the laparoscopic group were not significantly different from those in the laparotomy group (t=1.209, 1.585; P>0.05). The amount of surgical bleeding, the anal exhaust time and the length of stay in the laparoscopic group were significantly less than those in the laparotomy group (t=13.834, 5.930, 6.556; P<0.05); the postoperative continence function of the laparoscopic group was significantly better than that of the laparotomy group, and the difference was statistically significant (Z=-2.183, P=0.029); before operation, the anal sphincter systolic pressure (t=1.381, P=0.397), the maximum anal contraction time (t=1.047, P=0.297), and anal rest pressure (t=0.483, P=0.495) were not significantly different between the two groups; three months after surgery, the laparoscopic group of patients with anal sphincter pressure, the maximum contraction time, anal anal resting pressure were significantly higher than that in the open group, the difference was statistically significant (t=3.571, 5.188, 3.448; P<0.05). The complication rate of the laparoscopic group was 7.25%, which was significantly lower than that of the laparotomy group 17.78% (χ²=4.003, P=0.045).

laparoscopic TME combined with ISR is effective in the treatment of low rectal cancer, and has less trauma and good postoperative anal function.