Abstract:

Objective

To investigate the application value of laparoscopic transanal one-stage pull-through coloanal anastomosis with no protective stoma （LOPC） in the anal preservation treatment of low rectal cancer.

Methods

A retrospective descriptive research was conducted.Retrospective analysis of the clinical and pathological data of 21 patients with T1～T2 stage low rectal cancer treated with LOPC at He'nan Provincial People's Hospital from February 2020 to March 2023.There were 11 males and 10 females，with a median age of 56 （40～69） years.The patient's intraoperative and postoperative surgical indicators，complications， anal function， and tumor recurrence were all recorded.The deadline for follow-up is September 1，2023.

Results

All 21 patients successfully completed LOPC and retained their anus， without any conversion to open surgery or changes in surgical methods.The median surgical time was 200 （115～280） minutes， with a median bleeding volume of 100 （50～200） milliliters.No protective stoma was performed， and all patients were eligible for R0 resection.An average of 17 （12～26） lymph nodes were cleared， and the average hospital stay was 10 （7～13） days.There were no postoperative anastomotic leakage or perioperative deaths.All patients received postoperative follow-up， with a median follow-up of 12 （6～41） months and a LARS score of 26 （19～40） points at 6 months postoperatively.There was no tumor recurrence or metastasis during the follow-up period.

Conclusion

LOPC is safe and effective for the treatment of low rectal cancer.

Key words: Rectal neoplasms, Laparoscopy, Anterior resection, Coloanal anastomosis