经自然腔道取标本完全腹腔镜下结直肠癌根治术的应用探讨

Discussion on the application of total laparoscopic radical resection of colorectal cancer by natural orifice specimen extraction

目的比较经自然腔道取标本完全腹腔镜下结直肠癌根治术与传统腹腔镜结直肠癌手术的临床疗效。方法选择2017年9月—2018年11月本院收治的结直肠癌患者60例作为研究对象,随机数表法分为对照组与观察组两组,每组各30例。对照组行传统腹腔镜治疗,观察组行经自然腔道取标本完全腹腔镜下结直肠癌根治术治疗,比较两组手术情况、术后生活质量及并发症。结果观察组术中出血量为(63.12±5.28) ml,低于对照组的(83.46±7.24) ml;下床活动时间、术后排气时间、住院时间短于对照组,差异有统计学意义(P<0.05)。观察组术后生活质量评分总分为(83.41±5.28)分,高于对照组的(79.05±4.23)分,差异有统计学意义(t=3.246,P<0.05)。观察组并发症发生率为6.67%,低于对照组的26.67%,差异有统计学意义(P<0.05)。结论经自然腔道取标本完全腹腔镜下结直肠癌根治术可减少术中出血量,缩短患者住院时间,减少并发症,促进快速康复,提升患者生活质量。

Objective To compare the clinical efficacy of complete laparoscopic radical resection of colorectal cancer by natural orifice specimen extraction and traditional laparoscopic colorectal cancer surgery.Methods Sixty patients with colorectal cancer admitted to the hospital from September 2017 to November 2018 were randomly divided into the control group and the observation group according to random number table method,with 30 cases in each group.The control group underwent conventional laparoscopic treatment.The observation group underwent complete laparoscopic radical resection of colorectal cancer by natural orifice specimen extraction.The operation,postoperative quality of life and complications were compared between the two groups.Results The intraoperative blood loss in the observation group(63.12±5.28 ml)was lower than that in the control group(83.46±7.24 ml),the time of getting out of bed,postoperative exhaust time,and hospitalization time were shorter than the control group,the difference was statistically significant(P<0.05).The total score of postoperative quality of life in the observation group was(83.41±5.28),which was higher than that of the control group(79.05±4.23),and the difference was statistically significant(t=3.246,P<0.05).The occurrence rate of complication of the observation group was 6.67%,which was lower than that of the control group(26.67%),and the difference was statistically significant(P<0.05).Conclusions Complete laparoscopic radical resection of colorectal cancer by natural orifice specimen extraction could reduce the amount of intraoperative blood loss,shorten the hospitalization time,reduce complications,promote rapid recovery and improve the quality of life of patients.