中国经自然腔道取标本手术41 841例开展现状分析：2022年医师调查报告

目的了解我国经自然腔道取标本手术（NOSES）开展现状，为NOSES发展提供重要参考依据。 方法基于微信问卷形式，针对我国从事普通外科、肿瘤外科、妇科等专业的医师展开调查。调查内容包括医师基本信息、我国NOSES开展情况、NOSES技术培训与科研现状。 结果本研究覆盖我国30个省份及地区，共收集1 292份有效问卷调查表，其中开展NOSES医生为833人，占64.5%，未开展NOSES医生为459人，占35.5%。我国开展NOSES的医院共559家，开展NOSES总例数为41 841例，其中结直肠肿瘤NOSES为35 007例，胃肿瘤NOSES为4 381例，其他疾病NOSES为2 453例。根据不同取标本途径分类，经肛门取标本NOSES共33 728例，经阴道取标本NOSES为7 676例，经口取标本NOSES为437例。我国开展NOSES课题研究的医师占24.4%；发表NOSES论文的医师占20.2%。关于我国NOSES数据库情况，71.7%的医师未将NOSES数据上传至中国NOSES数据库。对于未来NOSES发展，91.3%的医师建议加强技术规范化培训，72.1%的医师建议向基层医生推广。 结论NOSES已在我国全面普及，地域分布广泛。为进一步推进NOSES临床应用，面向基层的规范化培训是医生的迫切需求，也是NOSES未来重要发展方向。

Analysis on the current situation of 41 841 cases of natural orifice specimen extraction surgery in China: surgeon's investigation report in 2022

ObjectiveTo understand the current status of natural orifice specimen extraction surgery (NOSES) in China and provide an important reference for the development of NOSES. MethodsBased on the form of WeChat questionnaire, a survey was conducted on Chinese physicians engaged in general surgery, surgical oncology, and gynecology and other specialties. The survey included the basic information of physicians, the development of NOSES in China, the current situation of NOSES technical training and research. ResultsThe study covered 30 provinces and regions in China, and 1 292 valid questionnaires were collected, including 833 physicians (64.5%) who performed NOSES and 459 physicians (35.5%) who did not perform NOSES. A total of 559 hospitals in China have implemented NOSES, and the total number of NOSES cases is 41 841, including 35 007 cases of colorectal tumor NOSES, 4 381 cases of gastric tumor NOSES, and 2 453 cases of NOSES for other diseases. According to different ways of specimen extraction, there were 33 728 cases taken through the anus, 7 676 cases taken through the vagina, and 437 cases taken through the mouth. According to the survey, 24.4% of physicians in China have carried out research on NOSES topics; 20.2% of physicians have published NOSES papers. Regarding the Chinese NOSES database, 71.7% of physicians did not upload NOSES data to this database. For the future development of NOSES, 91.3% of physicians suggested strengthening technical standardization training, and 72.1% of physicians suggested promoting it to grassroots doctors. ConclusionsNOSES has been fully popularized in China with wide geographical distribution. In order to further promote the clinical application of NOSES, standardized training for primary care is an urgent need for physicians and an important direction for the future development of NOSES.