孙氏减孔直肠癌NOSES手术4例报道

Sun's hole-reducing NOSES operation for rectal cancer: A report of 4 cases

目的探讨肿瘤上方先切断肠管裁剪系膜联合直肠残端腔内支撑牵引法完成减孔直肠癌NOSES手术(命名为孙氏减孔直肠癌NOSES手术)操作的技术要点和临床应用前景。方法 2018年12月吉林大学第一医院胃结直肠外科对4例术前评估均适合行NOSES手术的中低位直肠癌患者采取肿瘤上方切断并裁剪系膜后直肠残端腔内支撑牵引的方法完成直肠癌减孔NOSES手术。结果 4例患者中男3例,女1例;年龄46～71岁;肿瘤距离肛门5～10 cm。患者均顺利完成手术,平均手术时间(123.0±21.3)min,术中出血量(76.2±17.3)ml。术后恢复顺利,无相关并发症发生,于6日内康复出院。结论肿瘤上方先切断肠管裁剪系膜联合直肠残端腔内支撑牵引法完成减孔直肠癌NOSES手术安全可靠,具有较高应用价值。

Objective To explore the technical points and clinical application prospects of hole-reducing NOSES operation for rectal cancer by cutting the intestinal canal and the mesentery above the tumor integrating supporting and tracting rectal stump by supporting rod in rectal cavity(named Sun's hole-reducing NOSES operation). Methods In December 2018, the Department of Gastrointestinal and Colorectal Surgery of the First Hospital of Jilin University evaluated 4 patients with low and middle rectal cancer who were suitable for NOSES operation. The operation was performed by cutting the intestinal canal and the mesentery above the tumor integrating supporting and tracting rectal stump by supporting rod in rectal cavity. Results Among the 4 patients, there were 3 males and 1 females, ranging from 46 to 71 years old, and the distance between the tumors and the anus was 5 to 10 cm. All patients successfully completed the operation. The average operation time was ( 123.0± 21.3) minutes. The intraoperative bleeding volume was (76.2±17.3) ml and recovered smoothly. No complications occurred. The patients recovered and discharged within 6 days. Conclusions It is safe and reliable to perform hole-reducing NOSES for rectal cancer by cutting the intestinal canal and the mesentery above the tumor integrating supporting and tracting rectal stump by supporting rod in rectal cavity.