A novel technique for low-rectal cancer: Pushing the anus in laparoscopic radical resection

In sphincter-preserving surgery for low-rectal cancer, it is significant to reduce the number of stapler cartridges and the incidence of anastomotic leakage. Therefore, this study introduces a new and safer technique in laparoscopic radical resection of low-rectal cancer to reduce the number of stapler cartridges used during operation and reduce the incidence of postoperative anastomotic leakage. Information was collected on 237 patients with rectal cancer from the Affiliated Hospital of Southwest Medical University between January 2015 and July 2020. In 151 cases, the surgeon used the stapler cartridges (Ethicon Intraluminal Linear Staplers EC60A, Ethicon) to transect the edge of tumor of the rectum (conventional surgery group; n = 151). In other cases, besides applying the stapler cartridges, the surgeon had the assistant push the anus forward from the perineum during the process of transecting the rectum (pushing the anus group; n = 62). The postoperative outcomes and complications were compared between the 2 groups. As a result, in terms of the number of the stapler cartridges, the pushing the anus group was less than the conventional surgery group (P < .001). Moreover, the incidence of anastomotic leakage in the pushing the anus group is lower than that in the conventional surgery group (P = .043). These results proved that with pushing the anus forward during the process of transecting the rectum, the sphincter-preserving surgery can be performed more safely.