结直肠肿瘤经自然腔道取标本手术的影响因素分析

Analysis of the influencing factors of colorectal tumor through natural orifice specimen extraction surgery

目的了解我国经自然腔道取标本手术(NOSES)开展现状,探讨结直肠肿瘤NOSES的影响因素。方法对830名外科医师进行问卷调查,内容包括医师基本情况、结直肠肿瘤NOSES手术开展情况等。结果共发出问卷830份,回收有效问卷807份(97.2%)。68.8%(555/807)的外科医师所在医院级别为三甲,华中和华东地区占52.8%(426/807),高级职称占74.8%(604/807),69.1%(558/807)的外科医师开展结直肠肿瘤NOSES手术。三甲级医院、对NOSES理论体系掌握好和每年完成结直肠肿瘤手术例数超过50例是外科医师开展NOSES的促进因素(均P<0.05)。三甲级医院和对NOSES理论体系掌握好是外科医师开展经阴道取标本NOSES的促进因素(均P<0.05)。结论我国外科医生开展结直肠肿瘤NOSES势头较好,提升NOSES理论体系的掌握程度或将成为促进外科医生开展结直肠肿瘤NOSES手术的重要手段。

Objective To understand the current situation of natural orifice specimen extraction surgery(NOSES)in China,and analyse the influencing factors.Methods Eight hundred and thirty surgeons were investigated by questionnaire.The contents of the survey include the basic informations and the operation of NOSES in colorectal cancer.A total of 830 questionnaires were sent out and 807 valid questionnaires(97.2%)were collected.Results Sixty eight point eight percent(555/807)of the surgeons were in the grade A tertiary hospital,52.8%(426/807)were in Central and East China,74.8%(604/807)were senior professional titles,69.1%(558/807)of the surgeons per-formed NOSES in colorectal tumors.Grade A tertiary hospital,good grasp of the theoretical system of NOSES and more than 50 cases of colorectal cancer surgery completed each year were the promoting factors of NOSES(all P<0.05).Tertiary hospital,good grasp of the theoretical system of NOSES were the promoting factors of transvaginal-NOSES(all P<0.05).Conclusions Chinese surgeons have a good tendency in performing NOSES in colorectal cancer.To improve the mastery of the theoretical system of NOSES may become an important means to promote NOSES in colorectal cancer.