经自然腔道取标本完全腹腔镜下结直肠癌根治术的研究*

Effect of total laparoscopic resection for colorectal cancer by NOSE*

摘要:

目的 通过观察经自然腔道（NOSE）取标本完全腹腔镜下结直肠癌根治术术中和术后生活质量 情况，探讨该技术的可行性及临床疗效。方法 纳入2015 年4 月-2017 年6 月符合NOSE 法条件的40 例结 直肠癌患者，随机分为对照组（传统腹腔镜）和NOSE 组，每组20 例。观察分析两组患者的术中情况和术后 生活质量。结果 所有患者均按照预期目标完成手术，无中转其他手术方式者。两组患者均无术后并发症发 生。两组患者的手术时间和术中出血量差异有统计学意义（P <0.05），住院时间差异无统计学意义（P >0.05）， NOSE 组术后生活质量评分（SF-36 量表）在躯体功能、疼痛、角色、认知情况及整体健康状况5 个维度上 优于对照组，差异有统计学意义（P <0.05）。结论 NOSE 法完全腹腔镜下结直肠癌根治术具有整体健康状 况好、日常工作和生活受限少、躯体功能和角色功能恢复快等优点，因而对符合条件的患者可推广应用。

Abstract:

Objective To investigate the operation process of the technology, safety and operability of total laparoscopic resection for colorectal cancer by natural orifice specimen extraction (NOSE). Methods 40 patients with colorectal cancer who met the inclusion criteria of NOSE method from April 2015 to June 2017 were randomly divided into control group (traditional laparoscope) and experimental group (NOSE group), 20 cases in each. The intraoperative and postoperative quality of life between the two groups were statistically analyzed. Results All the patients completed the target operation, and no other operative methods were transferred. No complications occurred in either group. There were statistically difference (P < 0.05) between the two groups of patients in the two indicators (time and blood loss), there was no statistically significant difference in hospital time (P > 0.05), there was statistically difference (P < 0.05) between the two groups of quality of life score (SF-36 scale) in somatic function, role function, pain, cognitive and overall health status of five dimensions, the NOSE group was superior to the traditional laparoscopic group. Conclusion There are advantages in totally laparoscopic colorectal cancer treated with whole NOSE method. The overall health is good, few restrictions on daily work and life, quicker recovery of physical function and role function. Therefore, the application can be promoted if the condition is allowed.