关键词: 低位直肠癌, 腹腔镜, 加固缝合吻合口, 手术视野

Abstract: Objective To study the effect of "anal pushing" method on distal intestinal disconnection and reinforced suture anastomosis and closure in endoscopic assisted resection of low rectal cancer.Methods From December 2022 to December 2024, 85 patients who underwent endoscopic assisted anterior resection of rectum (Dixon) in our department were reviewed.The patients were divided into two groups according to whether to give "anal pushing" when the distal intestinal canal of the tumor was broken and the anastomoses and closures were reinforced during the operation.There were 41 cases in the observation group, who were treated with the "anal pushing" method, and 44 cases in the control group, who were treated with the traditional method.The number of anastomoses and closures, perioperative related indicators, postoperative laboratory test results, postoperative complications and so on were compared between the two groups.Results In the observation group, there were 27 cases(65.85%) of patients with abdominal reinforcement suture anastomosis and closure, which were significantly more than those in the control group[17 cases(38.64%)] (P<0.05).In the observation group, the number of times the linear cutting closure device was used to sever the distal tumor was 32 times, the time to reinforce the anastomosis was (9.89±1.88) minutes, the operation time was (188.66±26.32) minutes, the postoperative ventilation time was (3.93±4.98) days, and 7 cases (17.07%) underwent prophylactic ileostomy.The control groups were 21 times, (13.45±3.76) minutes, (209.50±19.45) minutes, (4.98±1.87) days and 16 cases (36.36%) respectively.There was a statistically significant difference between the two groups (P < 0.05).Conclusion The "anal pushing" is conducive to the exposure of the distal bowel of low rectal cancer, reducing the number of times of using the closure device, better exposing the anastomotic and closure in the surgical field, accelerating the speed of reinforcement and suture, and promoting the rehabilitation of patients.

Key words: low rectal cancer, laparoscopy, reiforced suture anastomosis, operative field