The academic value of this topic is to explore the feasibility and safety of laparoscopic-assisted radical colorectal cancer resection in primary hospitals, improve the technology, observe the clinical effect and summarize the clinical experience. With the rapid development of laparoscopic minimally invasive technology, laparoscopic colorectal cancer resection has been carried out in China for nearly 10 years, and has been developing rapidly because of its advantages of less injury, less postoperative pain, faster recovery of intestinal function, earlier resumption of feeding and activity, no additional perioperative complications, and shorter hospitalization time, and has initially It has achieved good results. However, it should be noted that when laparoscopic surgery is applied in oncology surgery, some doctors and patients still have doubts about the safety and curative effect due to the limited field exposure and unfavorable to the extensive lymph node dissection. In 2005, our hospital carried out laparoscopic radical surgery for colorectal cancer, and this project is designed to make a clinical comparison study between prospective and concurrent traditional open surgery in clinical and pathological aspects, in order to explore the value of laparoscopy in the treatment of colorectal cancer. 1. Data and methods 1.1 Clinical data 12 cases of laparoscopic radical colorectal cancer (laparoscopic group) were performed in our hospital between February 2004 and October 2008, excluding patients with preoperative symptoms of intestinal obstruction or perforation, diagnosis of stage T4 and tumor diameter over 6 cm. There were 11 male cases and 9 female cases. Eight cases underwent Dixon surgery and four cases underwent Miles surgery. The age was 24-81 years (mean 56 years). The tumor diameter was 2 cm to 5.5 cm (mean 3.6 cm). 12 cases of open radical rectal cancer were performed (open group), including 5 males and 7 females. Dixon surgery was performed in 7 cases and Miles surgery in 5 cases. The age was 26-75 (mean 51) years. The tumor diameter was 1.5cm-6cm (average 3.4cm), 3 cases were in TNM stage I, 6 cases were in TNM stage II, 3 cases were in TNM stage III, 1 case was highly differentiated, 5 cases were moderately differentiated and 6 cases were hypofractionated. 1.2 Equipment and surgical methods Applied equipment: TV laparoscopic high-definition camera and display system, automatic high-flow pneumoperitoneum machine, flushing and suction device, video recording and image storage equipment. One German-made laparoscope, laparoscopic conventional surgical instruments. Special equipment: including ultrasonic knife (Ultracision), bipolar electrocoagulator, one American Johnson ultrasonic knife, one Japanese fiberoptic colonoscope, various models of American laparoscopic sublinear cutting closures and circular anastomoses. After general anesthesia with tracheal intubation, the position taken varies according to the location of the tumor, with left hemicolectomy in the right oblique supine position, right hemicolectomy in the left oblique supine position, and rectal cancer in the head-low-hip-high cystotomy position. The operator is located on the opposite side of the lesion, and sometimes the left and right positions are switched. The observation hole is located at the umbilicus, and the location of the operating hole is often left and right epigastric (flat umbilicus or umbilicus parallel to the lower part of the umbilicus) and left and right Mack’s point, which can be selected or changed according to the location of the lesion and intraoperative needs, and the number of Trocar is 2 to 5, with different models of 5mm, 10mm and 12mm. The pneumoperitoneum pressure is ll to 15 mmHg. The principles, removal scope and freeing process of laparoscopic colorectal cancer surgery are basically the same as those of open surgery, except for the first case with electrocoagulation hook, the rest of cases are dissected with ultrasonic knife, only that titanium clips and wire ties can be used when leaving short vessels. The length of the incision is determined by the size of the specimen, generally 4-6 cm, and the pneumoperitoneum is eliminated, and a plastic protective layer is placed inside the incision. After removing the free colon, additional freeing is usually required, and both traditional needle and thread sutures and anastomosis can be used for anastomosis. The rectal tumor is resected according to the principle of total rectal mesenteric resection, the surrounding lymph nodes are cleared along the course of the inferior mesenteric vessels, the inferior mesenteric vessels or superior rectal artery are dissected and intracavernous knots are tied to sever the inferior mesenteric vessels, the anterior sacral space is separated downward at the level of sacral headland with ultrasonic knife, then the left sigmoid mesentery is separated to the level of peritoneal reflex, and the left ureter is protected, the sigmoid mesentery is severed by intracavernous knots in bundles, and the lateral wall of the rectum is separated from the pelvic plexus with ultrasonic knife. The pelvic plexus was separated by ultrasonic knife to reach the surface of the anal raphe, and the anterior sacral plexus should not be damaged when separating the posterior rectal space. A small incision of 4-6 cm was made in the middle and lower abdomen to remove the intestinal segment, and the sigmoid colon was severed at 10-15 cm from the upper edge of the tumor. The anterior sacral anastomosis is performed under direct vision or under lumpectomy with re-establishment of the pneumoperitoneum. In contrast, non-anal-preserving surgery, i.e., the Miles procedure, is performed with a combined abdominal perineum, complete removal of the tumor, and the creation of an artificial anus in the left lower abdomen. Like open surgery, laparoscopic colorectal cancer surgery should also follow the tumor-free principle, i.e., no-touch and isolation techniques, operate away from the tumor, do not touch and squeeze the tumor, block the distal intestinal canal of the tumor, and perform intra-intestinal chemotherapy and intraperitoneal infusion chemotherapy. The principle of TME should also be strictly followed during rectal cancer surgery. Any one-sided pursuit of minimally invasive laparoscopy with reduced resection scope, relaxation or abandonment of the tumor-free principle and sacrifice of tumor radicality is wrong. 1.3 Observation indexes ①Surgery-related indexes: operation time, blood loss, feeding time, blood transfusion cases, intermediate open abdomen, intraoperative complications. ②Postoperative recovery indexes: time of anal venting, time of removal of indwelling catheter, days of hospitalization. ③ Postoperative complications and follow-up results: tumor perforation, anastomotic fistula, anastomotic stricture, incisional infection, pulmonary infection, intestinal obstruction, etc. 1.4 Statistical treatment SPSS11.0 statistical software was used for statistical analysis. t-test was used for the mean test, x2 test was used for the rate test, and all t-test values were expressed as ±s. The difference was considered statistically significant at P<0.05. 2, Results The perioperative clinical data of patients in the laparoscopic group and the open group, performing laparoscopic surgery and open surgery should be comparable. The surgical conditions and complications of the two groups are shown in the following table, and the results showed that there were differences between the laparoscopic group in terms of blood loss, feeding time, hospitalization days, and incisional infection and the open surgery group (P<0.05); there was no anastomotic failure, anastomotic leak, urinary tract infection, fever, and re-hospitalization in the laparoscopic group; however, there were no differences between the laparoscopic group and the open surgery group in terms of operating time, blood transfusion cases, complications, reoperation, and so on (P> 0.05). In the laparoscopic group, there were 2 cases of intermediate open surgery, no death and no ureteral injury.