Abstract: Objective To explore the value of double tunnel approach through membranous space in laparoscopic surgery for low rectal cancer. Methods A retrospective study of 60 patients with low rectal cancer who underwent laparoscopic surgery in Ningxia Medical University General Hospital from January 2020 to April 2021 were selected as the research subjects. According to the differences of operation methods, they were divided into the study group (n=30, double tunnel method through membranous space approach) and the control group (n=30, conventional laparoscopic radical surgery). The general operation data of the two groups (operation time, intraoperative bleeding, hospital stay, postoperative ventilation time) were compared Postoperative indexes (anastomotic leakage, anastomotic stenosis,celiac hemorrhage, incidence of incision infection), pelvic neuroprotective effect (sexual function, micturition function score and anal sphincter defecation control ability at 1, 3 and 6 months after operation) and long-term follow-up (anastomotic bleeding, abdominal bleeding, prophylactic fistula, deep venous thrombosis and pulmonary embolism). Results The operation time and intraoperative blood output of the study group were higher than those of the control group, but the hospital stay and postoperative ventilation time were lower than those of the control group. The difference between the groups was statistically significant (P<0.05); there were 1 case of anastomotic leakage, 1 case of anastomotic stenosis and 1 case of incision infection in the study group, 2 cases of anastomotic leakage, 1 case of abdominal bleeding and 2 cases of incision infection in the control group. There was no significant difference in postoperative indexes between the two groups (P>0.05); at 1 month, 3 months and 6 months after operation, the urinary function scores of the patients in the study group were significantly lower than those in the control group, and the sexual function scores were significantly higher than those in the control group. The stool control ability scores were significantly higher than those in the control group, and the difference between the two groups was statistically significant (P<0.05). At 3 months and 6 months after operation, the scores of urination function and sexual function in the two groups were lower than that of one month before operation, and the defecation control ability was significantly higher than that of one month after operation, and the difference between groups was statistically significant (P<0.05); there were no deep venous thrombosis and pulmonary embolism in both groups after operation. The follow-up for 1 year showed no local recurrence, distant metastasis and death. Conclusion Intermembrane approach double tunnel method has good application value in laparoscopic low rectal cancer surgery, can significantly improve postoperative urinary function, sexual function and defecation control ability, and the operation is safe.

Key words: interstitial approach, double tunnel method, laparoscopy, low rectal cancer, clinical value