经自然腔道取标本改良Bacon术在低位直肠癌中的应用

Application of improved Bacon surgery for low rectal cancer with natural orifice specimen extraction surgery

目的:探讨改良Bacon术中经自然腔道取标本治疗低位直肠癌的可行性、适应证及近期疗效。方法:收集行经自然腔道取标本改良Bacon术的低位直肠癌患者的临床资料,分析术后排气时间、淋巴结清扫数量、住院时间、并发症等。结果:35例患者均顺利完成手术,中位手术时间140 min,中位手术出血量50 m L,中位术后恢复排气时间48 h,中位术后住院时间6 d。35例患者远端切缘均为阴性,中位淋巴结清扫数量15枚,术后发生拖出肠管回缩1例。结论:选择合适的患者,经自然腔道取标本的低位直肠癌改良Bacon术切实可行,安全可靠,近期疗效满意。

Objective:The aim of this study was to evaluate the feasibility,indication and short-term outcomes of improved Bacon surgery for low rectal cancer with natural orifice specimen extraction surgery.Methods:From Jun.2016 to Mar.2018,thirty-five patients with rectal cancer were treated by improved Bacon surgery for low rectal cancer with natural orifice specimen extraction surgery,and the data of these patients were collected and retrospectively analyzed to assess the value of this technique,including postoperative first bowel movement time,number of dissected lymph nodes,hospital stay,complications and so on.Results:All operations were successfully accomplished.The median operation time was 140 min.The median blood loss was 50 mL.The median time of first bowel movement was 48 h.The post-operative hospital stay was 6 d.All distal margins were negative and the mean number of dissected lymph nodes was 15.One patient had intestinal retraction.Conclusions:Improved Bacon surgery for low rectal cancer with natural orifice specimen extraction surgery appears to be feasible,safe and oncologically acceptable with a satisfactory short-term outcome for selected cases.