两种手术方法治疗直肠癌的中远期随访比较  

Mid-and long-term follow-up comparison of two surgical methods for rectal cancer

作　　者：郝君锋 魏红侠 雷凯 Hao Junfeng;Wei Hongxia;Lei Kai(Xi'an Ninth Hospital,Xi'an Shaanxi Province 710054,China)

机构地区：[1]西安市第九医院,西安710054

出　　处：《中华普外科手术学杂志（电子版）》2022年第4期462-464,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：陕西省社会发展科技公关项目(2016SF-226)。

摘　　要：目的比较经自然腔道取标本术(NOSES)与混合微创/开放手术(HMOA)治疗直肠癌的安全性及中远期随访评价结果。方法回顾性分析2013年6月至2015年9月接受手术治疗的122例直肠癌患者病例资料,根据术式不同分为两组,即NOSES组(n=64例)和HMOA组(n=58例)。采用SPSS23.0统计软件分析数据,手术相关指标等计量资料以(x±s)表示,采用独立样本t检验;术后并发症、复发率等计数资料采用χ^(2)检验;累积生存率采用Log-Rank检验。P<0.05为差异有统计学意义。结果NOSES组手术时间长于HMOA组,患者术后排气时间、住院时间均比HMOA组短(P<0.05);术中出血量、淋巴结清扫数量、术后3年、5年生存率及复发率比较,两组差异无统计学意义(P>0.05);NOSES组并发症总发生率比HMOA组低(10.9%vs.25.9%,P<0.05)。结论与混合微创/开放手术相比,经自然腔道取标本术治疗直肠癌手术具有明显微创性,术后并发症风险较低,且患者术后恢复较快,但两者中远期复发率、生存率无明显差异。Objective To compare the safety and long-term fllow-up evaluation of natural oni fice specimen extraction sugery(NOSES)and hybrid minimally invasivelopen approach(HM0A).Methods 122 patients with rectal cancer treated between June 2013 and September 2015 were analyzed retrospectively,which were divided into two groups according to diferent surgical procedures。namely the NOSES group(n=64 cases)and HMOA group(n=58 cases).SPSS 23.0 statistical software was used 1o analyxe the dala.The measurement data,such as surgery-related indicators,were expressed as(x±s)and compared by independent sample t test.Postoperative complications and recurrence rate,were compared by χ^(2) test.The cumulative survival rate was tested by Log-Rank test.P<0.05 was saistically signifcant.Results The operation time in the NOSES group was longer than that in the HM0A group,and the postoperative exhaust time and hospital stay were shorter than those in the HMOA group(P<0.05);There were no significant differences in intraoperative blood loss,number of lymph node dissections,3-year or 5-year survival rate and the recurrence rate between two groups(P>0.05);the total incidence of complications in the NOSE group was lower than that in the HMOA group(10.9% ts.25.9%)(P<0.05).Conclusion Compared with HMOA,NOSES is a more obvious minimally invasive,with lower risk of postoperative complications and faster postoperative recovery,but there is no significant difference in long-term recurrence rale and survival rate between the two surgical methods.

关 键 词：直肠肿瘤 经自然腔道取标本术 混合微创/开放手术 手术后并发症 生存状况 

分 类 号：R73[医药卫生—肿瘤]