中高位直肠癌经自然腔道手术与传统腹腔镜手术的对比研究

A Comparative Study of Middle and High Rectal CanceROperated by Natural Orifice Specimen Extraction Surgery(NOSES) and Traditional Laparoscopic Colorectal Resection(LCR).

目的探讨腹部无辅助切口经自然腔道中高位直肠癌根治术的可行性、安全性与近期临床疗效。方法采取回顾性研究收集2017年1月至2019年7月在我院普外一科接受经自然腔道取标本手本(NOSES)的中高位直肠癌患者31例(试验组),同期接受LCR的中高位直肠癌患者46例(对照组)进行对比研究,对两组患者临床病理资料、术中、术后情况、病理特点、术后并发症等进行统计学分析。结果两组患者术中出血量、手术时间、淋巴结切除数量等比较,差异无统计学意义(P>0.05);试验组患者疼痛评分(VAS)、住院时间及术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论中高位直肠癌NOSES术式安全、可行,且手术创伤小,术后恢复快,疼痛更轻,近期疗效满意。

Objective To investigate the feasibility,safety and recent clinical effect of radical resection of middle and high rectal cancer operated by natural orifice specimen extraction surgery(NOSES)without abdominal incision.Methods A total of 31 patients underwent natural orifice specimen extraction surgery without abdominal auxiliary incision for middle and high rectal cancer(experimental group)at a general department of the fourth people s hospital of Zigong city from January 2017 to July 2019.A total of 46 cases who underwent traditional laparoscopic resection for middle and high rectal cancer(control group)in the same period were also collected.Retrospective study was conducted to collect and analyze the clinicopathological data of the two groups of patients.The postoperative conditions,pathological features and postoperative complications were compared,respectively.Results Intraoperative bleeding,operation time and number of lymph node dissection were compared between the two groups,and the results showed no statistical difference(P>0.05).Compared with the traditional laparoscopy group,patients of the NOSES group had lower VAS score,shorter postoperative hospital stay and lower postoperative complications(P<0.05).Conclusion Laparoscopic transvaginal specimen extraction surgery without abdominal auxiliary incision for middle and high rectal cancer is safe and feasible.It has advantages of less surgical trauma and pain,rapid recovery and satisfactory of short-term efficacy.