NOSES在腹腔镜结直肠手术中的应用进展

The application progress of NOSES in laparoscopic colorectal surgery

腹腔镜技术在结直肠手术领域已得到广泛普及,相比开腹手术,它能减少创伤,促进患者术后康复。然而,为了取出标本,腹腔镜辅助手术一般需要建立腹部辅助切口,这会增加患者术后疼痛及发生切口相关并发症的风险。经自然孔道内镜手术(NOTES)旨在消除腹部切口,达到无疤痕手术的目的,但受限于特殊的器械及高难的技术,目前无法推广。经自然腔道取标本手术(NOSES)强调在目前已成熟的常规微创技术基础上,经人体自然腔道取出标本,从而避免了腹部大切口,因此在理论上容易接受,在实践中易于推广。

Laparoscopy has been widely used in the ?eld of colorectal surgery. Compared with open surgery, it can reduce incision-related trauma and promote postoperative rehabilitation. However, in order to extract the specimens, laparoscopy-assisted surgery generally requires an abdominal incision, which increases the risk of postoperative pain and incision-related complications. Natural orifice transluminal endoscopic surgery(NOTES) aims to avoid abdominal incision and achieve scar-free surgery, which can not be popularized at present for the limitation of special instruments and dif?cult technologies. Natural ori?ce specimen extraction surgery(NOSES)emphasizes the specimen is removed through the natural lumen of the human body on the basis of the mature conventional minimally invasive technique, which can avoid the large incision of abdomen. Therefore, NOSES is easy to be accepted in theory and popularized in practice.