关键词: 腹腔镜经腹ISR, 传统开腹ISR, 研究

Abstract: Objective To support the clinical dada in comparison between laparoscopic and traditional open abdominal intersphincteric resection（ISR）. Methods In this retrospective case-controlled study，90 colorectal cancer cases with anal sphincter preservation surgery were recruited from January 2013 to August 2015 in our hospital for treatment，in which 45 cases received open ISR （control group），and other 45 cases underwent laparoscopic transabdominal ISR（observation group）. The operative time，blood loss，regular mealtimes，flatus，complications，and length of stay，number of lymph node dissection，far margin length，positive circumferential resection margin and local recurrence rate ， mortality and anal functions between the two groups were compared. Results The operation time，flatus time，normal diet time，postoperative hospital stay（185.26 ± 15.89 min，2.61 ± 0.21 d，6.15 ± 1.14 d，7.59 ± 1.15 d） in the observation group were significantly shorter than those in the control group （223.02 ± 21.35min，3.26±0.411 d，7.58±0.98 d，9.58±0.64 d）（all P values <0.05）. Blood loss and the postoperative complications were significantly lower in the observation group （157.26 ± 12.54 mL， 4.44%）than in the control group（214.58±30.15 mL，20.00%），（P<0.05 for all）. No difference of the number of lymph node dissection and far margin length were found between the two groups （P>0.05）. The circumferential positive margin rate，the rate of local recurrence，distant metastasis and mortality were significantly lower in the observation group （4.44% ，2.22% ，0.00% ，2.22%） than that in the control group（20.00% ，15.56% ，11.11% ，22.22%），（P<0.05 for all）；The defecation urgency，stool frequency and bowel problems were lower significantly in the observation group than in the control group patients （P<0.05）. No significant difference of Wexner were found between the two groups （P>0.05）. Conclusion Laparoscopic abdominal ISR surgery in ultralow colorectal cancer has better clinical efficacy and safety.

Key words: traditional open ISR, research, laparoscopic transabdominal ISR