Work

A single-center retrospective cohort study on the effects of different surgical routes on complications after radical resection of low rectal cancer

Year: 2025

Type: article

Abstract: OBJECTIVE: To compare the impact of retromesenteric versus anterior mesenteric approaches on postoperative outcomes after laparoscopic radical resection for low rectal cancer. METHODS: This single-center retrospective cohort study included 157 patients (59 retromesenteric, 98 anterior mesenteric) treated between 2020 and 2023. Primary outcomes were postoperative inflammatory response, including C-reactive protein (CRP) and procalcitonin (PCT) levels on days 1, 3, and 7. Secondary outcomes included complications and recovery indicators. Logistic regression adjusted for confounders. RESULTS: Baseline characteristics were comparable. On postoperative day 1, CRP (68.4 ± 12.3 vs. 85.2 ± 14.7 mg/L, P < 0.01) and PCT (0.45 ± 0.08 vs. 0.61 ± 0.10 ng/mL, P < 0.01) were significantly lower in the retromesenteric group, with similar trends on day 3. Anastomotic leakage was less frequent in the retromesenteric group (6.2% vs. 18.4%, P = 0.048), confirmed as an independent protective factor in multivariable logistic regression analysis (OR = 3.16, 95% CI: 1.009-9.894). No significant differences were observed in incisional infection, ileus, or intra-abdominal infection (P > 0.05). Time to first flatus was shorter in the retromesenteric group (48.6 ± 6.3 vs. 52.3 ± 7.1 h, P < 0.01), while hospital stay and 30-day readmission rates were similar. CONCLUSION: The retromesenteric approach is superior to the anterior mesenteric approach in reducing postoperative inflammatory reactions and the risk of anastomotic leakage, and promotes postoperative intestinal function recovery, which provides an important basis for the selection of surgical approaches for low rectal cancer. TRIAL REGISTRATION: Not applicable.

Source: BMC Surgery

DOI: 10.1186/s12893-025-03454-y

Authors: Ruifeng Ye, Weixin Wu, Chongbiao Chen, Long Yi, Qin Gao

Institutions: Fujian University of Traditional Chinese Medicine, Fujian Medical University

Language: English

Topic: Colorectal Cancer Surgical Treatments

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090