To evaluate the value of intraoperative accurate measurement of the distance from the distal rectal edge to the promontory of the sacrum(Drp) in accurate anastomosis of laparoscopic rectal cancer surgery.

Thirty-nine patients with low-middle rectal cancer undergoing laparoscopic surgery who were admitted to General Surgery Department of Shannxi Provincial People's Hospital from January 1, 2019 to October 1, 2020 were included. Clinical data were collected and surgical videos were reviewed. Intraoperative measurement was performed as follows: Line segment was used to measure the Drp; The left semicolon and its mesangium were stretched at the level of the promonium of the sacrum and A titanium clip was used to mark the corresponding colon as point A; Starting from point A, the original Drp line segment was used to measure the proximal resection line of rectal cancer from point A to Drp+3 cm. Colorectal end-to-end anastomosis was performed, and enteral decompression was performed through anal indwelling anal canal. Patients underwent terminal ileostomy after neoadjuvant chemoradiotherapy. The evaluation indexes include intraoperative, postoperative and specimen quality. Descriptive statistical methods were used in this study.

The operative time was (247±57)min, and the intraoperative blood loss was estimated at (35±15)mL. The splenic flexure of the colon was mobilized before anastomosis in 7 cases. There were no cases of pelvic colon "bridging" after anastomosis, and the pelvic colon was relaxed after anastomosis through the anterior sacral area. There were no cases of free proximal colon after anastomosis and the mesangium was trimmed again. The Drp (17.7±4.6) cm, the distance from the proximal resection margin was (16.4±3.2) cm, and the distance from the distal resection margin was (2.3±1.1) cm. The specimen quality of total rectal mesorectal resection was grade A. There were no positive cases at the distal resection margin of rectal cancer. There was no anastomotic leakage after surgery. One patient had anastomotic bleeding. Exhaust time was (3.1±1.2) d, defecation time was (3.4±1.6) d, and postoperative hospitalization time was (9.1±2.3) d.

Measuring the Drp can accurately determine the proximal colon length and promote accurate anastomosis in laparoscopic radical rectal resection.