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

  • 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。

     

    Abstract:
    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 complications 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.

     

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