After more than 10 years of development, transanal total mesorectal excision (taTME) has played an important role in anus-preserving surgery for low rectal cancer. Existing studies have shown that taTME is not significantly different from traditional laparoscopy in the short-term and long-term efficacy of the treatment of low rectal cancer, and that taTME has potential advantages in postoperative functional recovery. With the maturity of taTME technology, transanal endoscopic approach has gradually been clinically applied to other rectal tumors, anastomotic stenosis, lateral lymph node dissection and other scenarios. Clinical practice shows that the transanal endoscopic approach can dissect pelvic tissues more accurately, greatly reduce the difficulty of surgery for complex pelvic diseases, improve the safety of surgery, and provide new ideas for clinical practice.
Objective To investigate the effect and clinical significance of 3 d and 1 d bowel preparation method for colorectal carcinoma surgery on preoperative gut mucosal barrier function. Methods Plasma levels of D-lactate (D-LAC), diamine oxidase (DAO) and endotoxin (ET) were measured at 2 h before operation in 3 d bowel preparation group (50 cases) and 1 d bowel preparation group (50 cases), 25 cases of inguinal hernia were included as control group. D-LAC, DAO and ET were detected by using enzymatic spectrophotometric assay, spectrophotometric assay and limulus lysate test with azo chromogenic substrate, respectively. Results Preoperative plasma levels of D-LAC, DAO and ET in 3 d bowel preparation group were (10.25±1.43) mg/L, (5.82±0.80) U/ml and (10.11±1.41) ng/L respectively. In 1 d bowel preparation group the corresponding values were (10.19±1.35) mg/L, (5.80±0.81) U/ml and (9.82±1.35) ng/L respectively. There were no significant differences between 3 d and 1 d bowel preparation group (Pgt;0.05), compared with hernia group, 1 d and 3 d bowel preparation group were also no statistically significant differences (Pgt;0.05). Conclusions There are no significant preoperative gut mucosal barrier function damages in patients with 1 d and 3 d bowel preparation for colorectal carcinoma surgery, 1 d bowel preparation for colorectal carcinoma surgery can be performed in colorectal carcinoma patients, and 3 d bowel preparation can be used for certain special colorectal carcinoma patients.