直肠癌经自然腔道取标本手术两种抵钉座置入方法的对比研究

A Comparative Study of Two Methods of Insertion of Anvil in Rectal Cancer Natural Orifice Specimen Extraction Surgery

目的:探讨直肠癌经自然腔道取标本手术(NOSES)中两种吻合器抵钉座置入方法的优缺点。方法:回顾分析笔者所在医院2017年5月-2019年9月由同一组医生完成的82例直肠癌经自然腔道取标本手术的临床资料,分为两组,A组40例采用反穿闭合法,B组42例采用留线闭合牵出法。比较两组患者手术时间、抵钉座置入时间、术中出血、术后恢复流质饮食时间、住院时间等指标。结果:82例均顺利完成手术,围手术期无死亡。两组术中出血量、手术时长、直肠充气试验发生率差异无统计学意义(P>0.05);A组抵钉座置入时间小于B组,但差异无统计学意义(P>0.05)。术后恢复流质饮食时间、术后住院时间、吻合口瘘发生率和总并发症发生率比较差异无统计学意义(P>0.05)。结论:两组种吻合器抵钉座置入方法均安全可靠,操作时间及术后恢复无明显差异,都可作为直肠癌NOSES的抵钉座置入方法。

Objective:To investigate the advantages and disadvantages of two kinds of anvil insertion methods in the operation of rectal cancer natural orifice specimen extraction surgery(NOSES).Method:Retrospective analysis 82 cases of rectal cancer operated by the same group of doctors in our hospital from May 2017 to September 2019.They were divided into two groups.In group A,40 cases were closed after reverse puncture,and in group B,42 cases were closed and pulled with suture.The general information,operation time,time of anvil insertion,intraoperative bleeding,postoperative recovery the time of rehydration diet and hospitalization of the two groups were compared.Result:All the 82 cases completed the operation successfully,and there was no death in the perioperative period.There was no significant difference between the two groups in the amount of bleeding,the length of operation and the incidence of rectal inflation test(P>0.05).There was no significant difference in anvil insertion time between group two groups(P>0.05).There was no significant difference in the time of fluid diet recovery,postoperative hospital stay,anastomotic leakage and total complications(P>0.05).Conclusion:Both of the two groups of stapler placement methods are safe and reliable,and there is no significant difference in operation time and postoperative recovery.