NOSES-Ⅳ式在完全腹腔镜高位直肠癌手术中的应用

The application of total laparoscopic surgery for high rectal cancer with NOSES Ⅳ type

目的探讨经自然腔道取标本手术(NOSES)Ⅳ式在完全腹腔镜高位直肠癌治疗中的安全性及近期临床疗效。方法选取2018年5月~2020年10月期间于我院行NOSESⅣ式手术的高位直肠癌患者23例作为观察组(NOSES组);另选择同一时期行传统腹腔镜手术的高位直肠癌患者25例作为对照组(传统腹腔镜组)。采用回顾性分析,比较两组的临床疗效。结果①两组在手术时间、术中出血量、排气时间、术后吻合口漏、腹腔感染和淋巴结清扫数量等方面差异均无统计学意义(P>0.05);②观察组在术后腹部疼痛、切口感染率、住院时间方面明显优于对照组,差异具有统计学意义(P<0.05)。结论NOSESⅣ式在高位直肠癌的治疗中是安全有效,切实可行的,且近期疗效优于传统腹腔镜手术。

Objective To investigate the safety and short term clinical effect of total laparoscopic surgery for high rectal cancer with NOSES Ⅳ type.Methods Twenty-three patients with high rectal cancer who underwent NOSES Ⅳ operation in our hospital from May 2018 to October 2020 were selected as the observation group(NOSES group).Twenty-five comparable cases who underwent traditional laparoscopic surgery at the same time were selected as the control group(traditional laparoscopy group).Retrospective cohort study was conducted to collect and analyze the clinicopathological data of two groups.Results①There were no significant difference between the two groups in terms of operation time,blood loss,first exhaust time,postoperative anastomotic leakage,abdominal infection and number of lymph node dissection(P>0.05).②The postoperative hospital stay,postoperative pain and Incision infection in experimental group were better than control group,differences were significant between two groups(P<0.05).Conclusion NOSESⅣfor therapy of high rectal cancer is safe and feasible,and their short-term efficacy is superior to traditional laparoscopy surgery.