加速康复外科理念下经自然腔道取标本手术治疗结直肠癌围手术期疗效

Perioperative efficacy of NOSES in treating colorectal cancer following enhanced recovery principles

目的评价加速康复外科理念(ERAS)联合经自然腔道取标本手术(NOSES)应用于结直肠癌围手术期安全性及疗效。方法回顾性分析2016年6月至2018年8月开展的20例接受腹腔镜手术治疗的结直肠癌患者资料,10例行NOSES手术(NOSES组)、10例行常规腹腔镜手术(常规组),两组患者围手术期均采取ERAS处理措施管理,数据采用SPAA19. 0软件统计分析。手术相关指标、术后评价指标数据以(x珋±s)表示,独立t检验;术后并发症等计数资料采用卡方检验; P <0. 05具有统计学意义。结果 NOSES组患者在术中出血量、术后疼痛、排气时间、离床时间、进食时间、排便时间、住院天数方面均优于常规组(P <0. 05);两组患者在手术时间及淋巴结清扫数目方面差异无统计学意义(P> 0. 05)。无围手术期无相关并发症。结论加速康复外科理念指导下的NOSES技术应用于结直肠肿瘤手术,在围手术期安全性及疗效肯定,值得进一步研究推广。

Objective To evaluate the safety and efficacy of NOSES in treating colorectal cancer following enhanced recovery principles. Methods From June 2016 to August 2018,20 patients with colorectal cancer who underwent laparoscopic surgery,including 10 cases of NOSES(NOSES group),and 10 cases of routine laparoscopic surgery(conventional group),patients in both two groups received perioperative ERAS treatment.Clinical data were analyzed by using statistical software SPSS 19.0.Measurement data such as perioperative indicators were expressed as mean±standard deviation,and independent t test was used for comparison between the groups.Count data,such as postoperative complication rate were expressed as%,and were examined by using χ^2 test.A P value<0.05 was considered as statistically significant difference. Results Clinical data of patients in the NOSES group were better than those in the conventional group in terms of intraoperative blood loss,postoperative pain,exhaust time,bedtime,eating time,defecation time,and length of hospital stay,with significant difference(P<0.05).The operation time and harvested lymph nodes were similar between two groups(P>0.05).There were no complications in both groups. Conclusion The NOSES based on ERAS concept could be applied in colorectal cancer surgery,with satisfactory safety and efficacy,which is worth further research and promotion.