经自然腔道取标本手术在右半结肠癌根治术中的应用优势与技术要点

Advantages and Key Technical Points of Laparoscopic Right Colon Cancer Resection with Natural Orifice Specimen Extraction Surgery

随着微创外科理念的发展,经自然腔道取标本手术(NOSES)逐步在右半结肠癌根治术中被广泛应用。经阴道或直肠取标本的方式避免了腹部切口,使患者术后疼痛减轻,减少术后住院康复时间,并取得良好的美容效果。但右半结肠解剖结构复杂,对全腔镜下重建消化道的技术要求较高,经阴道或直肠取标本的方式也遭受了很多争议,对普遍开展造成了困难。全文结合自身经验对NOSES术在右半结肠癌根治术中的应用优势与技术要点进行讨论。

With the development of the minimally invasive surgery,natural orifice specimen extraction surgery(NOSES)has been widely used in the radical resection of right colon cancer.The method of taking specimens through the vagina or rectum not only avoids abdominal incisions,but also alleviates the postoperative pain,reduces the hospital recovery time,and achieves good cosmetic effects.However,the anatomical structure of the right colon is complex,and the technical requirements for the reconstruction of the digestive tract under full laparoscopic surgery are rela-tively high.The method of taking specimens through the vagina or rectum has also met a lot of controversies,which may cause difficulties for its development.This article will discuss in detail the advantages and key technical points of the application of NOSES in the right colon based on author’s own experience.