Laparoscopic total mesorectal excision and anal sphincter preservation for patients with rectal cancer:A single center experience with 611 cases

Objective To investigate the applicative indication,procedure selection,operating essentials and therapeutic effect of laparoscopic total mesorectal excision with anal sphincter preservation in patients with rectal cancer.Methods Six hundred and eleven patients from a single center were studied for surgical and short term results.Results Altogether 174 patients received coloanal anastomosis,while 204,104 and 129 patients underwent high,low and ultra-low colorectal anastomosis,respectively.The average time for the operation was 117.8 minutes and blood loss was 28.5 ml.Nine patients had intraoperative rectal perforation,while 27 patients had anastomic leakage.The average time for liquid intake and hospitalization was 2.8 and 8.4 days after surgery,respectively.Thirty-two patients suffered from postoperative urinary dysfunction while 91.8% of the patients who had had low/ultralow anastomosis showed well-controlled defecation.Conclusions Laparoscopic TME is similar to open procedure in application and validity.The sharp dissection between the parietal and visceral pelvic fascia is essential to prevention of damage to adjacent tissues and postoperative complications.