经自然腔道取标本完全腹腔镜下结直肠癌根治术的研究*

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(P0.05),住院时间差异无统计学意义(P0.05),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(P0.05)。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。

Effect of total laparoscopic resection for colorectal cancer byNOSE*

Objective To investigate the operation process of the technology, safety and operability of totallaparoscopic resection for colorectal cancer by natural orifice specimen extraction (NOSE). Methods 40 patientswith colorectal cancer who met the inclusion criteria of NOSE method from April 2015 to June 2017 were randomlydivided into control group (traditional laparoscope) and experimental group (NOSE group), 20 cases in each. Theintraoperative and postoperative quality of life between the two groups were statistically analyzed. Results Allthe patients completed the target operation, and no other operative methods were transferred. No complicationsoccurred in either group. There were statistically difference (P < 0.05) between the two groups of patients in the twoindicators (time and blood loss), there was no statistically significant difference in hospital time (P > 0.05), there wasstatistically 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 thetraditional laparoscopic group. Conclusion There are advantages in totally laparoscopic colorectal cancer treatedwith whole NOSE method. The overall health is good, few restrictions on daily work and life, quicker recovery ofphysical function and role function. Therefore, the application can be promoted if the condition is allowed.