NOTES腹腔镜下直肠癌根治术治疗直肠癌的效果  

The Effect of Laparoscopic Radical Resection of Rectal Cancer in the Treatment of Rectal Cancer by NOTES

作　　者：王辉[1] 刘爱芬 WANG Hui;LIU Ai-fen(General Surgery,Tianjin Public Security Hospital,Tianjin 300042,China;Department of Anesthesiology,the Second Affiliated Hospital of Tianjin Medical University,Tianjin 300021)

机构地区：[1]天津市公安医院普外科,天津300042 [2]天津医科大学附属第二医院麻醉科,天津300021

出　　处：《医学信息》2020年第17期95-97,共3页Journal of Medical Information

基　　金：天津市公安局科研项目(编号:2017KYSGAY021)。

摘　　要：目的探讨经自然腔道内镜手术(NOTES)治疗直肠癌的效果。方法选取2018年1月~2020年6月我院经手术治疗的100例低位直肠癌患者作为研究对象,根据不同手术方法分为对照组54例和NOTES组46例。对照组采用传统腹腔镜低位直肠癌手术治疗,NOTES组采用NOTES手术治疗,比较两组手术时间、手术出血量、近切缘距肿瘤上缘距离、远切缘距肿瘤下缘距离、清扫淋巴结数目、术后3个月生存质量、手术并发症发生情况。结果两组手术时间、近切缘距肿瘤上缘距离、远切缘距肿瘤下缘距离、清扫淋巴结数目比较,差异无统计学意义(P>0.05);NOTES组手术出血量低于对照组,差异有统计学意义(P<0.05);NOTES组手术并发症发生率为15.22%,与对照组的27.78%比较,差异无统计学意义(P>0.05);术后3个月,NOTES组躯体功能、角色功能、躯体疼痛、整体健康状况评分高于对照组,差异有统计学意义(P<0.05);两组情绪功能、认知功能、社会功能、精力评分比较,差异无统计学意义(P>0.05)。结论NOTES治疗直肠癌的效果与传统腹腔镜手术效果相当,但出血量更少,术后患者的生存质量更好。Objective To investigate the effect of natural endoscopic surgery(NOTES)in the treatment of rectal cancer.Methods A total of 100 patients with low rectal cancer who had undergone surgery in our hospital from January 2018 to June 2020 were selected as the research objects.According to different surgical methods,they were divided into control group 54 cases and NOTES group 46 cases.The control group was treated with traditional laparoscopic low rectal cancer surgery,and the NOTES group was treated with NOTES surgery.The operation time,surgical blood loss,distance between the proximal resection edge and the upper edge of the tumor,the distance between the far resection edge and the lower edge of the tumor,and the number of lymph nodes were compared between the two groups,3 months after the operation,quality of life,surgical complications.Results There was no significant difference in the operation time,the distance between the proximal resection margin and the upper edge of the tumor,the distance between the distal resection margin and the lower edge of the tumor,and the number of lymph nodes dissected between the two groups(P>0.05);the surgical blood loss in the NOTES group was lower than that in the control group,there was statistical significance(P<0.05);the incidence of surgical complications in the NOTES group was 15.22%,compared with 27.78% in the control group,the difference was not statistically significant(P>0.05);3 months after surgery,the scores of physical function,role function,physical pain,and overall health in the NOTES group were higher than those of the control group,the difference was statistically significant(P<0.05);the two groups’emotional function,cognitive function,social function,energy score comparison showed no statistically significant difference(P>0.05).Conclusion The effect of NOTES in the treatment of rectal cancer was comparable to that of traditional laparoscopic surgery,but with less bleeding and better quality of life for patients after surgery.

关 键 词：经自然腔道内镜手术 直肠癌 生存质量 

分 类 号：R735.3[医药卫生—肿瘤]