3D腹腔镜经自然腔道取标本直肠癌根治术(NOSESⅣ式)的效果分析

Effect analysis of the 3D laparoscopic resection of rectal cancer with natural orifice specimen extraction surgery(NOSES typeⅣ)

目的:讨论3D腹腔镜经肛门取标本直肠癌根治术(NOSESⅣ式)的临床效果。方法:回顾分析2018年1月至2019年12月收治的154例直肠癌患者的临床资料,分别行3D腹腔镜手术(3D组,n=80)与2D腹腔镜手术(2D组,n=74例),从纳入的154例患者中使用倾向得分匹配法每组选入37例进行统计学分析。结果:3D组手术时间、出血量、排气时间、进食时间短于2D组,差异有统计学意义(P<0.05)。3D组组织识别度、深层次感觉、止血成功度、团队协调度更具有优势,差异有统计学意义(P<0.05);两组淋巴结清扫数量及吻合口漏、吻合口出血、切口感染、腹腔感染等术后并发症发生率差异无统计学意义(P>0.05)。结论:3D腹腔镜经肛门取标本直肠癌根治术可使患者手术近期获益。

Objective:To discuss the clinical effect of transanal resection of rectal cancer(NOSES TypeⅣ)under 3D laparoscopy.Methods:This study retrospectively analyzed the clinical data of 154 patients with rectal cancer from Jan.2018 to Dec.2019.The patients were divided into 3D laparoscopic group(80 cases)and 2D laparoscopic group(74 cases)to complete the surgical treatment.From the 154 selected patients,37 patients in each of the two groups were selected using the propensity score matching method for statistical analysis.Results:Operation time,blood loss,exhaust time,food intake time of 3D laparoscopic group were all shorter than those of 2D laparoscopic group(P<0.05).In terms of tissue recognition,deep sense,hemostatic success and team coordination of the 3D laparoscopic group had more advantages(P<0.05).There was no statistically significant difference in the number of lymph nodes dissected,anastomotic leakage,anastomotic hemorrhage,incision infection and abdominal infection between the two groups(P>0.05).Conclusions:Transanal resection of rectal cancer by 3D laparoscopy can benefit patients in the near term.