经自然腔道取标本手术对比传统腹腔镜手术在结直肠癌中的优势性及安全性分析

Analysis of the superiority and safety of natural orifice specimen extraction surgery compared with traditional laparoscopic surgery in colorectal cancer

目的比较经自然腔道取标本手术(NOSES)和传统腹腔镜手术治疗结直肠癌的优势性及安全性。方法2018年1月~2021年10月我科行结直肠癌手术的病人128例,其中60例行NOSES,68例行传统腹腔镜手术,对比两组术中、术后指标的差异。结果NOSES组和传统腹腔镜组切口长度分别为(3.93±0.10)cm和(10.77±1.23)cm,疼痛评分分别为(3.52±1.13)分和(4.12±1.11)分,首次下床时间分别为[(19.13±6.81)小时和(25.03±9.38)小时,排气时间分别为(52.23±14.05)小时和(61.59±16.87)小时,营养评分分别为(3.92±0.96)分和(4.41±1.04)分,住院时间分别为(11.22±2.22)天和(12.59±2.36)天,两组比较差异有统计学意义(P<0.05);两组手术时间分别为(142.41±20.28)分钟和(138.63±17.92)分钟,失血量分别为(62.58±35.68)ml和(66.03±51.34)ml,淋巴结清扫个数分别为(11.15±2.62)枚和(10.59±2.54)枚,并发症率分别为20.00%和22.06%,两组比较,差异无统计学意义(P>0.05)。结论NOSES在确保手术安全性时,在美观度、疼痛程度、康复方面,更具优势。

Objective To verify the superiority and safety of natural orifice specimen extraction surgery(NOSES)compared with traditional laparoscopic surgery in patients with colorectal cancer.Methods The clinical data of 128 patients underwent colorectal cancer surgery in our department from January 2018 to October 2021 were retrospectively analyzed,including 60 NOSES and 68 traditional laparoscopic surgery,and the differences of intraoperative and postoperative indicators were compared between the two groups.Results The NOSES group was superior to the traditional laparoscopic group in incision length[(3.93±0.10)cm vs(10.77±1.23)cm],pain score[(3.52±1.13)points vs(4.12±1.11)points],first activity time[(19.13±6.81)h vs(25.03±9.38)h],exhaust time[(52.23±14.05)h vs(61.59±16.87)h],nutrition score[(3.92±0.96)points vs(4.41±1.04)points],length of hospital stay[(11.22±2.22)d vs(12.59±2.36)d](P<0.05).There was no difference in operation time[(142.41±20.28)min vs(138.63±17.92)min],blood loss[(62.58±35.68)ml vs(66.03±51.34)ml],number of lymph nodes dissected[(11.15±2.62)vs(10.59±2.54)]and complications(20.00%vs 22.06%)between the two groups(P>0.05).Conclusion NOSES was more superior in aesthetics,pain and rehabilitation when ensuring the safety of surgery.