腹腔镜下结肠癌根治术中经肛自然腔道取标本的临床应用价值研究

Study on clinical application value of natural orifice specimen extraction in laparoscopic radical resection of colon cancer

目的探讨腹腔镜下结肠癌根治术中经肛自然腔道取标本的临床应用价值。方法140例接受腹腔镜下结肠癌根治术治疗的原发性结肠癌患者为研究对象,参照随机数字表法分为对照组及观察组,各70例。对照组患者接受传统腹壁辅助切口操作,观察组患者采取腹腔镜下结肠癌根治术中经肛自然腔道取标本。比较两组患者的手术相关指标(手术时间、术中出血量、术后第1天疼痛评分、术后排气时间、术后流质饮食时间、术后住院时间)及术后并发症发生情况、复发转移情况。结果两组患者的手术时间比较,差异无统计学意义(P>0.05);观察组患者的术中出血量(60.71±8.49)ml少于对照组的(72.64±9.82)ml,术后第1天疼痛评分(2.78±0.43)分低于对照组的(3.37±0.59)分,术后排气时间(2.77±0.54)d、术后流质饮食时间(4.11±0.58)d、术后住院时间(9.32±1.52)d短于对照组的(3.18±0.62)、(5.06±0.68)、(10.64±1.88)d,差异有统计学意义(P<0.05)。两组患者的术后并发症发生率比较差异无统计学意义(P>0.05)。两组患者的术后复发转移率比较差异无统计学意义(P>0.05)。结论腹腔镜下结肠癌根治术中经肛自然腔道取标本可加速患者的术后康复,且不会增加术后并发症发生率及远期复发转移率。

Objective To discuss the clinical application value of natural orifice specimen extraction in laparoscopic radical resection of colon cancer.Methods A total of 140 patients with primary colon cancer who underwent laparoscopic radical resection of colon cancer were divided into control group and observation group according to the random numerical table,with 70 cases in each group.Patients in the control group received traditional abdominal wall-assisted incision operation,and patients in the observation group received natural orifice specimen extraction in laparoscopic radical resection of colon cancer.Both groups were compared in terms of operation-related indexes(operative time,intraoperative blood loss,pain score on the 1st day after surgery,postoperative exhaust time,postoperative liquid diet time,postoperative hospital stay),postoperative complications,and postoperative recurrence and metastasis.Results There was no statistically significant difference in operative time between the two groups(P>0.05).The intraoperative blood loss of(60.71±8.49)ml in the observation group was less than that of(72.64±9.82)ml in the control group;the pain score of(2.78±0.43)points on the 1st day after surgery in the observation group was lower than that of(3.37±0.59)points in the control group;in the observation group,the postoperative exhaust time was(2.77±0.54)d,the postoperative liquid diet time was(4.11±0.58)d,and the postoperative hospital stay was(9.32±1.52)d,which were shorter than those of(3.18±0.62),(5.06±0.68),and(10.64±1.88)d in the control group;the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).There was no statistically significant difference in postoperative recurrence and metastasis rate between the two groups(P>0.05).Conclusion In laparoscopic radical resection of colon cancer,natural orifice specimen extraction can accelerate the postoperative recovery of patients,and will not increase the incidence of postoperative complications and long-term recurrence and metastasis rate.