NOSES术与常规腹腔镜手术对结直肠癌术后康复及并发症的影响对比

Comparison of the effects of NOSES and conventional laparoscopic surgery on postoperative rehabilitation and complications of colorectal cancer

目的:探讨经自然腔道取标本手术(NOSES)与常规腹腔镜手术对结直肠癌(CRC)患者术后康复及并发症的影响。方法:回顾性分析102例CRC患者的临床资料,其中接受NOSES根治术48例(研究组),接受常规腹腔镜根治术54例(常规组)。比较两组术后恢复情况、应激状态、康复情况及并发症发生情况。结果:研究组下床活动时间、住院时间、排气时间、肠鸣音恢复时间、胃肠蠕动时间均短于常规组(P<0.05);研究组术后超氧化物歧化酶(SOD)水平高于常规组(P<0.05),丙二醛(MDA)水平低于常规组(P<0.05);研究组术后1 d视觉模拟疼痛评分低于常规组(P<0.05);研究组术后7 d生活质量测定量表EORTC QLQ-C30评分高于常规组(P<0.05);两组并发症发生率差异无统计学意义(P>0.05)。结论:与常规腔镜手术治疗相比,NOSES术对CRC的治疗效果更好。

Objective:To investigate the effects of natural orifice specimen extraction(NOSES)and conventional laparoscopic surgery on postoperative recovery and complications in patients with colorectal cancer(CRC).Methods:The clinical data of 102 patients with CRC were retrospectively analyzed,including 48 patients who received NOSES radical resection for colorectal cancer(study group)and 54 patients who received conventional laparoscopic radical colorectal resection(routine group).The postoperative recovery,stress state,rehabilitation and complications were compared between the two groups.Results:The time of getting out of bed,hospital stay,exhaust time,bowel sound recovery time and gastrointestinal motility time in the study group were all shorter than those in the routine group(P<0.05).The postoperative superoxide dismutase(SOD)level in the study group was higher than that in the conventional group(P<0.05),and the level of malondialdehyde(MDA)was lower than that in the conventional group(P<0.05).The visual analog pain score in the study group was lower than that in the routine group 1 day after operation(P<0.05).The EORTC QLQ-C30 score of the quality of life measuring scale 7 days after operation in the study group was higher than that in the routine group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Compared with conventional laparoscopic surgery,NOSES has better therapeutic effect on CRC.