经直肠与经腹部小切口取出标本的腹腔镜乙状结肠癌根治术的比较  

Comparison of Laparoscopic Radical Resection of Sigmoid Colon Carcinoma With the Specimens Taking out Through Rectum or Small Abdominal Incision

作　　者：周仕海[1] 陈宏[1] 雒洪志[1] 冯春在[1] 孙浩 钟思权 Zhou Shihai;Chen Hong;Luo Hongzhi(Department of Tumor Surgery, Zhongshan People’s Hospital, Zhongshan 528403, China)

机构地区：[1]广东省中山市人民医院肿瘤外科,中山528403

出　　处：《中国微创外科杂志》2022年第4期303-307,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：中山市科技局基金项目(2020B1082)。

摘　　要：目的探讨经直肠取出标本的腹腔镜乙状结肠癌根治术的近期疗效和安全性。方法回顾性分析2018年11月~2020年12月130例腹腔镜乙状结肠癌根治术的临床资料,2个医疗组分别采用经直肠取出标本(NOSES组,n=52)和经腹部小切口取出标本(对照组,n=78)。比较2组手术时间、术中出血量、术后恢复和并发症。结果NOSES组术后第1天疼痛视觉模拟评分(Visual Analogue Scale,VAS)低[(1.8±0.7)分vs.(2.9±0.5)分,t=-9.940,P=0.000],下地活动早[(1.4±0.5)d vs.(2.4±0.6)d,t=-9.350,P=0.000],排气早[(2.8±0.7)d vs.(3.3±1.0)d,t=-3.635,P=0.000],术后住院时间短[(6.5±1.6)d vs.(7.3±2.6)d,t=-2.096,P=0.038],切口感染发生率低[0%(0/52)vs.10.3%(8/78),P=0.021],2组手术时间、术中出血量、吻合口漏、肠梗阻、腹腔出血、吻合口出血和总并发症发生率差异无统计学意义(P>0.05)。结论经直肠取出标本腹腔镜乙状结肠癌手术安全可行,近期疗效较好。Objective To analyze the short-term efficacy and safety of laparoscopic radical resection of sigmoid colon cancer with transrectal extraction of specimen.Methods From November 2018 to December 2020,130 patients underwent laparoscopic radical resection of sigmoid colon cancer in our hospital.Specimens were taken out through rectum(NOSES group,n=52)or small abdominal incision(control group,n=78).The operation time,intraoperative bleeding,postoperative recovery and complications were compared between the two groups.Results Compared to the control group,the Visual Analogue Scale(VAS)of pain on the first day after operation in the NOSES group was lower[(1.8±0.7)points vs.(2.9±0.5)points,t=-9.940,P=0.000],the underground activity was earlier[(1.4±0.5)d vs.(2.4±0.6)d,t=-9.350,P=0.000],the exhaust was earlier[(2.8±0.7)d vs.(3.3±1.0)d,t=-3.635,P=0.000],the postoperative hospital stay was shorter[(6.5±1.6)d vs.(7.3±2.6)d,t=-2.096,P=0.038],and the incidence of incision infection was lower[0(0/52)vs.10.3%(8/78),P=0.021].There was no significant difference in operation time,intraoperative bleeding,anastomotic leakage,intestinal obstruction,abdominal bleeding,anastomotic bleeding and the incidence of complications between the two groups(P>0.05).Conclusions It is safe and feasible to carry out the operation of laparoscopic radical resection of sigmoid colon cancer with transrectal extraction of specimen.The short-term curative effect of this operation is good.

关 键 词：经自然腔道取标本手术 乙状结肠癌 腹腔镜 

分 类 号：R73[医药卫生—肿瘤]