经自然腔道取标本手术在乙状结肠癌及高位直肠癌根治术中的应用

Application of natural orifice specimen extraction surgery in radical resection of sigmoid colic cancer and upper rectal cancer

目的:探讨经自然腔道取标本手术(NOSES)在乙状结肠癌及高位直肠癌治疗中的应用价值。方法:纳入2017年8月至2019年12月经肠镜活检病理确诊为乙状结肠癌或高位直肠癌的69例患者,其中对照组(n=43)行传统腹腔镜结直肠癌根治术,观察组(n=26)行腹腔镜NOSES结直肠癌根治术,对比分析两组术中、术后情况及并发症发生率。结果:两组手术时间、术中出血量、术后并发症发生率差异无统计学意义(P>0.05);观察组术后首次通气时间、术后住院时间、术后首次下床活动时间、首次进流质饮食时间短于对照组。观察组术后第1天有效睡眠时间更长、视觉疼痛评分低,差异有统计学意义(P<0.05)。结论:NOSES治疗乙状结肠癌及高位直肠癌可促进术后快速康复,缩短术后住院时间,提高术后舒适度,疗效较好,具有推广意义。

Objective:To explore the application of natural orifice specimen extraction surgery(NOSES)in the treatment of sigmoid colon cancer and high rectal cancer.Methods:A total of 69 patients with sigmoid colon cancer or high rectal cancer who had undergone preoperative colonoscopic biopsy from Aug.2017 to Dec.2019 were included in this study.43 cases in control group underwent conventional laparoscopic-assisted radical operation for colorectal cancer and 26 cases in observation group underwent laparoscopic NOSES radical resection of colorectal cancer,intraoperative and postoperative conditions and postoperative complications were compared between the two groups.Results:There was no significant difference in total operation time,intraoperative blood loss or the incidence of postoperative complications between the two groups(P>0.05).Compared with the control group,the time of postoperative first ventilation,postoperative hospital stay,the first postoperative ambulation and the first liquid diet was shorter,the effective sleep time was longer on postoperative day 1,and the visual pain score was lower in the observation group,the differences were statistically significant(P<0.05).Conclusions:In the treatment of sigmoid colon cancer and high rectal cancer,NOSES can promote rapid recovery,shorten the hospital stay,and improve postoperative comfort after surgery.Laparoscopic NOSES radical resection of colorectal cancer has good curative effect and is of great significance.