全腹腔镜下吻合、下腹部外横内纵切口取标本术(类-NOSES)在结直肠癌中的应用效果  

Effects of laparoscopic total anastomosis and abdominal transverse incision for specimen extraction surgery(quasi-NOSES) in treating colorectal cancer

作　　者：陈海鹏 马晓龙 原皓 杨明 赵志勋 关旭 姜争 周海涛 郑朝旭 刘正 王锡山 Chen Haipeng;Ma Xiaolong;Yuan Hao;Yang Ming;Zhao Zhixun;Guan Xu;Jiang Zheng;Zhou Haitao;Zheng Zhaoxu;Liu Zheng;Wang Xishan(Department of Colorectal Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of Anesthesia,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科,北京100021 [2]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院麻醉科,北京100021

出　　处：《结直肠肛门外科》2019年第3期253-258,共6页Journal of Colorectal & Anal Surgery

基　　金：中国医学科学院医学与健康科技创新工程项目(No.2016-I2M-1-001);北京市科技计划(No.D171100002617004);北京市科技计划(No.Z161100000116090)

摘　　要：目的探讨全腹腔镜下吻合、腹壁外横内纵小切口取标本术在结直肠癌患者中的应用效果。方法回顾性分析2016年1月至2019年2月在中国医学科学院肿瘤医院结直肠外科住院治疗的58例结直肠癌患者临床资料,患者均行结直肠癌根治术且均为全腹腔镜下吻合、腹壁外横内纵小切口取标本术式。分析患者手术时间、术中出血量、术后排气时间、住院时间、术后疼痛评分等手术相关指标,探讨该手术方式的安全性和有效性。结果58例患者均顺利完成手术,无中转开腹病例,中位手术时间134.50(91.50,174.75) min,中位切口长度5.00(5.00,5.25) cm,中位术中出血量20.00(20.00,50.00) mL,中位术后肛门排气时间3.00(3.00,3.00) d,中位住院时间7.00(6.00,7.25) d。术后当日中位疼痛评分2.50(1.00,3.00)分,术后第3 d中位疼痛评分1.00(1.00,1.25)分,术后第5 d中位疼痛评分0.00(0.00,1.00)分。结论全腹腔镜下吻合、腹壁外横内纵小切口取标本术在结直肠癌根治术中的应用安全、可行、值得推广。Objectives To investigate the effects of laparoscopic total anastomosis and abdominall transverse incision for specimen extraction surgery in treating colorectal cancer. Methods This was a retrospective analysis of 58 patients with colorectal cancer admitted to Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, between January 2016 and February 2019. All patients received radical surgery for colorectal cancer using laparoscopic total anastomosis and abdominal transverse incision for specimen extraction. The following were recorded: duration of surgery, intraoperative blood loss, postoperative anal exhaust time, duration of hospitalization, postoperative pain score. And the safety and effectiveness of the operation was explored. Results Surgery was uneventful in all 58 patients, with no conversion to open surgery. The median duration of surgery was 134.50 (91.50, 174.75) minutes, the median incision length was 5.00 (5.00, 5.25) cm, the median intraoperative blood loss was 20.00 (20.00, 50.00) mL, the median postoperative anal exhaust time was 3.00 (3.00, 3.00) days, and the median duration of hospitalization was 7.00 (6.00, 7.25) days. The median postoperative pain score was 2.50 (1.00, 3.00) at the 1st day after surgery, 1.00 (1.00, 1.25) at the 3rd day after surgery, and 0.00 (0.00, 1.00) at the 5th day after surgery. Conclusion Laparoscopic total anastomosis and abdominal transverse incision for specimen extraction was safe and effective in treating colorectal cancer.

关 键 词：结直肠癌 腹腔镜 吻合技术 经自然腔道取标本手术 类-NOSES术 安全性 效果 

分 类 号：R735.3[医药卫生—肿瘤]