腹腔镜直肠癌根治术经自然通道取标本的临床分析(1)
【摘要】 目的：探讨腹腔镜直肠癌根治术经自然通道取标本手术(NOSES)的临床治疗效果。方法：选取笔者所在医院直肠癌患者60例，均行腹腔镜直肠癌根治术。随机分为两组，各30例。试验组实施NOSES，对照组经开腹取标本，比较两组临床指标、并发症发生率、术后细菌株数、癌细胞数目、6个月后复发率、转移率及死亡率。结果：试验组切口疼痛明显少于对照组，排气时间、下床时间、住院时间均短于对照组，差异均有统计学意义(P<0.01)。术后两组细菌株数、癌细胞数目、并发症发生率、复发率、转移率、死亡率比较，差异均无统计学意义(P>0.05)。结论：腹腔镜直肠癌根治术NOSES具有创伤小、恢复快、预后好等优势，且不增加并发症发生率及死亡率，安全可行，值得临床推广。
【关键词】 直肠癌 腹腔镜直肠癌根治术 经自然通道取标本手术 临床疗效
doi：10.14033/j.cnki.cfmr.2020.19.056 文献标识码 B 文章编号 1674-6805(2020)19-0-03
Clinical Analysis of Laparoscopic Radical Resection of Rectal Cancer via Natural Orifice Specimen Extraction Surgery/LAO Jingmao， DENG Wei， WEI Xiaobo， LIU Guang. //Chinese and Foreign Medical Research， 2020， 18(19)： -139
[Abstract] Objective： To investigate the clinical effect of laparoscopic radical resection of rectal cancer via natural orifice specimen extraction surgery (NOSES). Method： Sixty patients with rectal cancer in our hospital were selected， all of whom underwent laparoscopic radical resection of rectal cancer. They were randomly divided into two groups， with 30 cases in each group. The experimental group received NOSES， and the control group received laparotomy for specimen. The clinical indicators， incidence of complications， number of bacterial strains， number of cancer cells， recurrence rate， metastasis rate and mortality after 6 months were compared between the two groups. Result： The incision pain in the experimental group was significantly less than that of the control group， and exhaust time， out of bed time and hospital stay were shorter than those of the control group， and the differences were statistically significant (P<0.01). The number of bacterial strains， number of cancer cells， incidence of complications， recurrence rate， metastasis rate and mortality were compared between the two groups， and the differences were not statistically significant (P>0.05). Conclusion： Laparoscopic radical resection of rectal cancer via NOSES has the advantages of little trauma， faster recovery， better prognosis， and no increcose in complications and mortality. It is safe and feasible， and is worthy of clinical promotion.
[Key words] Rectal cancer Laparoscopic radical resection of rectal cancer Natural orifice specimen extraction surgery Clinical efficacy
First-author’s address： The First People’s Hospital of Qinzhou， Qinzhou 535000， China
随着现代人们生活方式的改变，直肠癌发病率逐年上升，并呈现出年轻化趋势。腹腔镜手术具有创伤小、出血少、并发症少、恢复快等特点，已被广泛应用于临床中[1]。相较于腹腔镜直肠癌根治術经开腹取标本而言，经自然腔道取标本手术(NOSES)可减小腹壁瘢痕，且患者预后良好[2]。通过术中严格消毒，遵循无菌和无瘤原则，能够有效避免肿瘤细胞移植扩散，从而减少住院天数，提高生活质量。笔者所在医院对直肠癌患者行腹腔镜直肠癌根治术NOSES，效果满意，报道如下。, http://www.100md.com(劳景茂 邓伟 韦小波 刘广)
【关键词】 直肠癌 腹腔镜直肠癌根治术 经自然通道取标本手术 临床疗效
doi：10.14033/j.cnki.cfmr.2020.19.056 文献标识码 B 文章编号 1674-6805(2020)19-0-03
Clinical Analysis of Laparoscopic Radical Resection of Rectal Cancer via Natural Orifice Specimen Extraction Surgery/LAO Jingmao， DENG Wei， WEI Xiaobo， LIU Guang. //Chinese and Foreign Medical Research， 2020， 18(19)： -139
[Abstract] Objective： To investigate the clinical effect of laparoscopic radical resection of rectal cancer via natural orifice specimen extraction surgery (NOSES). Method： Sixty patients with rectal cancer in our hospital were selected， all of whom underwent laparoscopic radical resection of rectal cancer. They were randomly divided into two groups， with 30 cases in each group. The experimental group received NOSES， and the control group received laparotomy for specimen. The clinical indicators， incidence of complications， number of bacterial strains， number of cancer cells， recurrence rate， metastasis rate and mortality after 6 months were compared between the two groups. Result： The incision pain in the experimental group was significantly less than that of the control group， and exhaust time， out of bed time and hospital stay were shorter than those of the control group， and the differences were statistically significant (P<0.01). The number of bacterial strains， number of cancer cells， incidence of complications， recurrence rate， metastasis rate and mortality were compared between the two groups， and the differences were not statistically significant (P>0.05). Conclusion： Laparoscopic radical resection of rectal cancer via NOSES has the advantages of little trauma， faster recovery， better prognosis， and no increcose in complications and mortality. It is safe and feasible， and is worthy of clinical promotion.
[Key words] Rectal cancer Laparoscopic radical resection of rectal cancer Natural orifice specimen extraction surgery Clinical efficacy
First-author’s address： The First People’s Hospital of Qinzhou， Qinzhou 535000， China
随着现代人们生活方式的改变，直肠癌发病率逐年上升，并呈现出年轻化趋势。腹腔镜手术具有创伤小、出血少、并发症少、恢复快等特点，已被广泛应用于临床中[1]。相较于腹腔镜直肠癌根治術经开腹取标本而言，经自然腔道取标本手术(NOSES)可减小腹壁瘢痕，且患者预后良好[2]。通过术中严格消毒，遵循无菌和无瘤原则，能够有效避免肿瘤细胞移植扩散，从而减少住院天数，提高生活质量。笔者所在医院对直肠癌患者行腹腔镜直肠癌根治术NOSES，效果满意，报道如下。, http://www.100md.com(劳景茂 邓伟 韦小波 刘广)