腹腔镜直肠癌根治术经自然通道取标本的临床分析

Clinical Analysis of Laparoscopic Radical Resection of Rectal Cancer via Natural Orifice Specimen Extraction Surgery

目的:探讨腹腔镜直肠癌根治术经自然通道取标本手术(NOSES)的临床治疗效果。方法:选取笔者所在医院直肠癌患者60例,均行腹腔镜直肠癌根治术。随机分为两组,各30例。试验组实施NOSES,对照组经开腹取标本,比较两组临床指标、并发症发生率、术后细菌株数、癌细胞数目、6个月后复发率、转移率及死亡率。结果:试验组切口疼痛明显少于对照组,排气时间、下床时间、住院时间均短于对照组,差异均有统计学意义(P<0.01)。术后两组细菌株数、癌细胞数目、并发症发生率、复发率、转移率、死亡率比较,差异均无统计学意义(P>0.05)。结论:腹腔镜直肠癌根治术NOSES具有创伤小、恢复快、预后好等优势,且不增加并发症发生率及死亡率,安全可行,值得临床推广。

Objective:To investigate the clinical effect of laparoscopic radical resection of rectal cancer via natural orifice specimen extraction surgery(NOSES).Method:Sixty patients with rectal cancer in our hospital were selected,all of whom underwent laparoscopic radical resection of rectal cancer.They were randomly divided into two groups,with 30 cases in each group.The experimental group received NOSES,and the control group received laparotomy for specimen.The clinical indicators,incidence of complications,number of bacterial strains,number of cancer cells,recurrence rate,metastasis rate and mortality after 6 months were compared between the two groups.Result:The incision pain in the experimental group was significantly less than that of the control group,and exhaust time,out of bed time and hospital stay were shorter than those of the control group,and the differences were statistically significant(P<0.01).The number of bacterial strains,number of cancer cells,incidence of complications,recurrence rate,metastasis rate and mortality were compared between the two groups,and the differences were not statistically significant(P>0.05).Conclusion:Laparoscopic radical resection of rectal cancer via NOSES has the advantages of little trauma,faster recovery,better prognosis,and no increcose in complications and mortality.It is safe and feasible,and is worthy of clinical promotion.