基于荷包缝合腹腔镜NOSES在乙状结肠癌及上段直肠癌治疗中的应用价值  

Application value of laparoscopic natural orifice specimen extraction surgery based on purse-string suture for sigmoid colon and upper rectal cancer

作　　者：魏哲威[1] 刘宝忆 周皓 雷天翔 孙开宇[1] 宋武[1] Wei Zhewei;Liu Baoyi;Zhou Hao;Lei Tianxiang;Sun Kaiyu;Song Wu(Department of Gastrointestinal Surgery,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院胃肠外科中心,广州510080

出　　处：《中华消化外科杂志》2024年第6期853-858,共6页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(81702325,82203642);广东省基础与应用基础研究基金(2024A1515013235);广州市科技计划项目(202201011415、2023A04J2212)。

摘　　要：目的探讨基于荷包缝合腹腔镜经自然腔道取标本手术(NOSES)在乙状结肠癌及上段直肠癌治疗中的应用价值.方法采用回顾性描述性研究方法.收集2022年10月至2023年6月中山大学附属第一医院收治的14例行基于荷包缝合腹腔镜NOSES乙状结肠癌及上段直肠癌根治术患者的临床病理资料;男8例,女6例;年龄为(56±10)岁.观察指标:(1)手术情况.(2)术后情况.(3)随访情况.正态分布的计量资料以(x)±s表示.计数资料以绝对数表示.结果(1)手术情况.所有患者顺利行基于荷包缝合腹腔镜NOSES乙状结肠癌及上段直肠癌根治术,无中转开放手术.14例患者手术时间为(162±32)min,术中出血量为(22±12)mL.(2)术后情况.14例患者术后首次下床活动时间为(1.6±0.7)d,术后首次肛门排气时间为(2.1±0.6)d,术后首次饮水时间为(2.4±0.6)d,术后首次进食流质食物时间为(3.8±1.0)d,术后住院时间为(6.0±0.9)d.所有患者术后未发生吻合口漏、出血等围手术期并发症.(3)随访情况.14例患者均获得随访,随访时间为(9.7±1.9)个月.14例患者术后无复发、转移和死亡.结论基于荷包缝合腹腔镜NOSES用于治疗乙状结肠癌及上段直肠癌安全、可行.Objective To investigate the application value of laparoscopic natural orifice specimen extraction surgery(NOSES)based on purse-string suture for sigmoid colon and upper rectal cancer.Methods The retrospective and descriptive study was conducted.The clinicopathological data of 14 patients undergoing laparoscopic NOSES based on purse-string suture for sigmoid colon and upper rectal cancer in The First Affiliated Hospital of Sun Yat-sen University from October 2022 to June 2023 were collected.There were 8 males and 6 females,aged(56±10)years.Observation indicators:(1)surgical conditions;(2)postoperative conditions;(3)follow-up.Measurement data with normal distribution were represented as Mean±SD.Count data were described as absolute numbers.Results(1)Surgical conditions.All patients underwent laparoscopic NOSES based on purse-string suture for sigmoid colon and upper rectal cancer successfully,without conversion to open surgery.The operation time of 14 patients was(162±32)minutes,and the volume of intraoperative blood loss was(22±12)mL.(2)Postoperative conditions.Time to postoperative first out-of-bed activity,time to postoperative first flatus,time to postoperative first drinking,time to postoperative initial liquid food intake,duration of postoperative hospital stay of 14 patients were(1.6±0.7)days,(2.1±0.6)days,(2.4±0.6)days,(3.8±1.0)days,(6.0±0.9)days,respectively.None of patient had perioperative compli-cations such as postoperative anastomotic leakage and bleeding.(3)Follow-up.All 14 patients were followed up for(9.7±1.9)months.There was no postoperative recurrence,metastasis or death in 14 pati-ents.Conclusion The laparoscopic NOSES based on purse-string suture can be used for sigmoid colon and upper rectal cancer,which is safe and feasible.

关 键 词：结直肠肿瘤 乙状结肠 上段直肠 经自然腔道取标本 荷包缝合 疗效 安全性 腹腔镜检查 

分 类 号：R735.34[医药卫生—肿瘤]