临床普外科电子杂志 ›› 2022, Vol. 10 ›› Issue (3): 6-.

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结直肠肿瘤经肛自然腔道取标本手术与传统腹腔镜结直肠癌手术的临床对比研究

  

  1. 1. 福建医科大学 临床医学部,福建 福州 350000;2. 福建医科大学教学医院莆田市第一医院 胃肠外科一区,福建 莆田 351100
  • 出版日期:2022-07-01 发布日期:2022-10-21

A clinical comparison of transanal natural orifice specimen extraction surgery with traditional laparoscopic surgery for colorectal cancer

  1. 1.Clinical Medicine Department of Fujian Medical University, Fujian Fuzhou 350000, China; 2.The First Division of the Gastrointestinal Surgery Department of Putian First Hospital, Teaching Hospital of Fujian Medical University, Fujian Putian 351100, China
  • Online:2022-07-01 Published:2022-10-21

摘要:

目的 探讨经肛自然腔道取标本手术(natural orifice specimen extraction surgery,NOSES)与传统腹腔镜结直肠癌手术治疗乙状结肠癌、高位直肠癌手术的安全性和可行性。方法 回顾性分析2018 年10月至2020 年10 月福建医科大学教学医院莆田市第一医院30 例经肛NOSES 治疗腹腔镜乙状结肠癌、高位直肠癌手术患者(观察组)以及同期30 例采用传统腹腔镜乙状结肠癌、高位直肠癌手术患者(对照组)的临床资料,对比分析两组患者的手术时间、术中出血量、淋巴结清扫数量、术后第1 天疼痛评分、术后并发症、术后局部复发与远处转移等结果。结果 两组患者的术中出血量、淋巴结清扫数量、术后并发症发生率方面无显著差异(P > 0.05)。观察组患者的手术时间长于对照组,术后第1 天疼痛评分低于对照组,术后排气时间短于对照组,术后流质饮食时间短于较对照组,术后住院时间短于对照组,差异均有显著性(P< 0.05)。两组患者术后随访均未见肿瘤局部复发与转移。结论 经肛NOSES 乙状结肠癌、高位直肠癌手术是安全可行的,具有术后疼痛轻、恢复快、住院时间短的优点,并且肿瘤根治效果与传统腹腔镜手术相当。


关键词: 关键词:腹腔镜, 经自然腔道取标本手术, 结直肠癌

Abstract:

Objective To investigate the safety and feasibility of transanal natural orifice specimen extraction surgery (NOSES) laparoscopic surgery for sigmoid colon cancer and high rectal cancer. Method A retrospective analysis of clinical datas of 30 patients who underwent transanal NOSES laparoscopic surgery for sigmoid colon cancer and high rectal cancer(the observation group) and 30 patients who underwent conventional laparoscopic surgery for sigmoid colon cancer and high rectal cancer(the control group) during the same period, in Putian City from October 2018 to October 2020. A comparative analysis was conducted between these two groups in regard to the operation time, the intraoperative blood loss, the intraoperative lymph node dissection, the postoperative pain score of day 1, the postoperative complications and the postoperative local recurrence and distant metastasis. Result There were no significant differences in the intraoperative blood loss, the intraoperative lymph node dissection and the postoperative complications of both groups (P > 0.05). The operation time of the observation group was longer than that of the control group, the postoperative pain score of day 1 of the observation group was lower than that in the observation group, the postoperative exhaust time of the observation group was shorter than that in the control group, the postoperative fluid diet time in observation group was shorter than that in control group, the postoperative hospital stay in the observation group was shorter than that in the control group, the differences are significant (P < 0.05). Patients in both groups were followed up and no local and distant recurrence was observed.Conclusion Transanal NOSES laparoscopic surgery for sigmoid colon cancer and upper rectal cancer is safe and feasible. It has the advantages of light postoperative pain, quick recovery, short hospital stays, and the radical tumor treatment effect is comparable to that of traditional laparoscopic surgery.

Key words: Laparoscope surgery, Natural orifice specimen extraction surgery, Colorectal cancer