Study on the effects of modified laparoscopic low rectal anastomosis on anal-rectal function

ObjectiveTo explore the effects of the modified laparoscopic low rectal anastomosis on anal-rectal functions. MethodsA total of 74 patients who were admitted into our department from January 2015 to December 2016 and received laparoscopic low anterior resection were enrolled before retrospective analysis. Patients in Group A (n=36) were subject to laparoscopic anterior resection of prostate cancer through modified gastrointestinal anastomosis, while those in Group B (n=38) were provided with the traditional double anastomotic method of laparoscopic low anterior resection. Both groups were compared for age, gender, the distance from the tumor to the dentate line, TNM staging, and Wexner grading before surgery. Meanwhile, the distal margin distance, anastomotic height, and the length of distal anastomotic ring were recorded. The anal-rectal functions were evaluated through telephones and follow-up visits using the least angle regression scores (LARS) and Wexner scores. ResultsThere was no statistical significance in age, gender, the distance from the tumor to the dentate line, TNM staging, and Wexner grading before surgery between the both groups (P>0.05). The modification group showed higher anastomotic stoma height than the traditional anastomosis group (3.50±1.03 vs 2.87±1.10, P=0.01). Compared with the traditional group, the modification group produced better Wexner scores 3 months after surgery (8.61±2.44 vs 10.11±2.96, P=0.02) and 6 months after surgery (6.36±1.81 vs 7.55±2.32, P=0.02). Statistical difference was found as to LARS scores between the traditional and modification groups 3 months after surgery (P=0.04) and 6 months after surgery (P=0.02). ConclusionsThe modified laparoscopic anastomosis for low rectal carcinoma can improve anastomotic stoma height, reduce sphincter damage, and protect anal-rectal function after surgery. Key words: low rectal carcinoma; laparoscope; anal-rectal functions