男性低位直肠癌经自然腔道取标本手术的疗效观察

Observation on curative effect of natural orifice specimen extraction surgery in male low rectal cancer

目的探讨经自然腔道取标本手术(NOSES)在男性低位直肠癌中的疗效。方法将我院56例男性低位直肠癌患者按照随机数字表法分为观察组和对照组,每组28例。观察组行NOSES,对照组行腹腔镜下直肠癌前切除术,对比2组患者手术相关指标、术后住院期间指标、随访情况、术后生活质量及肛门功能。结果观察组远端切缘距离长于对照组,预防性造口少于对照组,差异均有统计学意义(P<0.05)。与对照组比较,观察组术后肠功能恢复时间更短、住院时间更短、术后7 d疼痛评分更低,差异均有统计学意义(P<0.05);2组患者术后3、6个月身体形象、大便失禁比较差异有统计学意义(P<0.05);2组患者术后3个月腹痛、肛门疼痛比较差异有统计学意义(P<0.05);观察组患者术后1年排便功能优于对照组(P<0.05)。结论NOSES治疗男性低位直肠癌简单易行,手术效果满意,安全可靠。

Objective To explore the curative effect of natural orifice specimen extraction surgery(NOSES)in male low rectal cancer.Methods A total of 56 male patients with low rectal cancer in our hospital were divided into the observation group and the control group according to the random number table method,with 28 cases in each group.The observation group was treated with NOSES,and the control group was treated with laparoscopic anterior resection of rectal cancer.The operation-related indicators,postoperative hospitalization indicators,follow-up status,postoperative quality of life and anal function were compared between the two groups.Results The distance of the distal incision margin in the observation group was longer than that in the control group,and the preventive stoma was less than that in the control group,the differences were all statistically significant(P<0.05).Compared with the control group,the observation group had shorter recovery time of postoperative intestinal function,shorter hospitalization time,and lower pain scores 7 days after operation,and the differences were all statistically significant(P<0.05).There were statistically significant differences in the body image and fecal incontinence 3 and 6 months after operation between the two groups of patients(P<0.05).There were statistically significant differences in the abdominal pain and anal pain 3 months after operation between the two groups of patients(P<0.05).The defecation function 1 year after operation in the observation group was better than that in the control group(P<0.05).Conclusion NOSES is a simple and effective method for the treatment of male low rectal cancer,with satisfactory surgical results,safe and reliable.