腹腔镜辅助手套通路经肛门微创术治疗中高位直肠肿瘤的短期疗效及安全性分析OA

Objective To compare the short-term efficacy and safety of laparoscopically assisted glove-port transanal minimally invasive surgery(LAP-TransAnal)and laparoscopic anterior resection(LAR)in the treat-ment of mid-high rectal neoplasms,so as to provide evidence-based basis for clinical surgical selection.Meth-ods A retrospective analysis was performed on the clinical data of 92 patients with stage T1-2 N0 mid-high rectal tumors who underwent surgical treatment in Longnan First People's Hospital from January 2022 to June 2025.The patients were divided into the LAP-TransAnal group(46 cases)and the LAR group(46 cases)according to the surgical method.Baseline data,surgery-related indicators,postoperative recovery indicators,positive rate of pathological resection margin after surgery,and incidence of complications within 30 days after surgery were compared between the two groups.The severity of complications was evaluated by the Clavien-Dindo classification system.Results There was no statistically significant difference in baseline data between the two groups(P>0.05).The operation time and intraoperative blood loss in the LAP-TransAnal group were significantly less than those in the LAR group(P<0.001),and there was no significant difference in the intra-operative blood transfusion rate between the two groups(P>0.05).The first postoperative exhaust time,the first postoperative oral intake time,and length of hospital stay in the LAP-TransAnal group were significantly shorter than those in the LAR group(P<0.001).There was no statistically significant difference in the posi-tive rate of postoperative pathological resection margin between the two groups(2.17%vs.4.35%,P>0.05).The total incidence of complications within 30 days after surgery in the LAP-TransAnal group was sig-nificantly lower than that in the LAR group(P<0.05),among which the incidence of intestinal obstruction(2.17%)was lower than that in the LAR group(10.87%)(P<0.05),while there was no significant differ-ence in the incidence of other complications between the two groups(P>0.05).All complications in both groups were classified as Clavien-Dindo grade Ⅰ-Ⅱ,with no grade Ⅲ-Ⅴ complications,and there was no sig-nificant difference in the distribution of complication grades between the two groups(P>0.05).Conclusion LAP-TransAnal in the treatment of stage T1～2 N0 mid-high rectal tumors can shorten the operation time,reduce intraoperative blood loss,and accelerate postoperative recovery.It has comparable safety in resection margin to LAR and fewer short-term complications,which is worthy of clinical promotion.