What question did this study set out to answer?

To evaluate how different surgical approaches impact complications after laparoscopic radical resection for low rectal cancer.

January 10, 2026BMC Surgery0 citationsOpen Access

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

Q: What does this research mean for the field?

The retromesenteric approach reduces postoperative CRP and PCT levels and the risk of anastomotic leakage to 6.2% compared to 18.4% for the anterior mesenteric approach in patients undergoing laparoscopic radical resection for low rectal cancer. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

RYRuifeng YeFujian University of Traditional Chinese Medicine WWWeixin WuIllumina (United States)CCC. ChenFujian University of Traditional Chinese Medicine

Key Result

The retromesenteric approach reduced postoperative CRP and PCT levels, and anastomotic leakage was significantly lower at 6.2% compared to 18.4% for the anterior approach (P = 0.048).

Key Points

To evaluate how different surgical approaches impact complications after laparoscopic radical resection for low rectal cancer.
Retrospective cohort study design.
Included 157 patients treated between 2020 and 2023.
Primary outcomes measured were C-reactive protein and procalcitonin levels.
Logistic regression analysis adjusted for confounding variables.
Lower CRP and PCT levels were observed in the retromesenteric group on postoperative day 1.
Anastomotic leakage occurred less frequently in the retromesenteric group (6.2% vs. 18.4%).
Shorter time to first flatus in the retromesenteric group (48.6 vs. 52.3 hours).
No significant differences in other complications like incisional infection or ileus.

Structured PICO

Does the retromesenteric approach reduce postoperative inflammatory response and complications compared to the anterior mesenteric approach in patients undergoing laparoscopic radical resection for low rectal cancer?

Population

157 patients undergoing laparoscopic radical resection for low rectal cancer treated between 2020 and 2023

Intervention

Retromesenteric approach for laparoscopic radical resection (n=59)

Comparator

Anterior mesenteric approach for laparoscopic radical resection (n=98)

Outcome

Postoperative inflammatory response, including C-reactive protein (CRP) and procalcitonin (PCT) levels on days 1, 3, and 7surrogate

The retromesenteric approach for low rectal cancer resection significantly reduces early postoperative inflammation and the risk of anastomotic leakage compared to the anterior mesenteric approach.

Main Result

Absolute Event Rate: 0% vs 0%

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 0.05). 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.

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