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中华普外科手术学杂志(电子版) ›› 2022, Vol. 16 ›› Issue (02) : 230 -232. doi: 10.3877/cma.j.issn.1674-3946.2022.02.030

论著

经自然腔道内镜手术与腹腔镜微创术治疗乙状结肠癌和高位直肠癌的长期随访比较
胡延伟1, 张红松2,(), 范晓彬1, 范现英1, 马竞优1, 王园园2   
  1. 1. 054001 河北邢台,邢台市第三医院普外科
    2. 050030 石家庄,河北医科大学第一医院普外科
  • 收稿日期:2020-12-29 出版日期:2022-04-26
  • 通信作者: 张红松

Comparison of long-term follow-up between natural cavity endoscopic surgery and laparoscopic minimally invasive treatment of sigmoid colon cancer and high rectal cancer

Yanwei Hu1, hongsong Zhang2,(), Xiaobin Fan1, Xianying Fan1, Jingyou Ma1, yuanyuan Wang2   

  1. 1. Xingtai Third Hospital General Surgery, Xingtai Hebei Province 054001, China
    2. Department of General Surgery, First Hospital of Hebei Medical University, Shijiazhuang Hebei Province 050030, China
  • Received:2020-12-29 Published:2022-04-26
  • Corresponding author: hongsong Zhang
  • Supported by:
    Hebei Provincial Health and Family Planning Commission Project(20150632)
引用本文:

胡延伟, 张红松, 范晓彬, 范现英, 马竞优, 王园园. 经自然腔道内镜手术与腹腔镜微创术治疗乙状结肠癌和高位直肠癌的长期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2022, 16(02): 230-232.

Yanwei Hu, hongsong Zhang, Xiaobin Fan, Xianying Fan, Jingyou Ma, yuanyuan Wang. Comparison of long-term follow-up between natural cavity endoscopic surgery and laparoscopic minimally invasive treatment of sigmoid colon cancer and high rectal cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(02): 230-232.

目的

比较经自然腔道内镜手术(NOTES)与传统腹腔镜微创术治疗乙状结肠癌和高位直肠癌的5年随访结果。

方法

回顾性分析2013年5月至2015年5月107例乙状结肠癌和高位直肠癌患者病例资料,根据术式不同分为NOTES组(52例)和传统组(55例)。采用SPSS 23.0统计分析软件,围术期各项指标以(

xˉ
±s)表示,采用独立样本t检验;并发症、生存率采用χ2检验;K-M检验分析并比较两组无进展生存期。P<0.05为差异有统计学意义。

结果

与传统组相比,NOTES组手术时间较长,术后排气时间、住院时间较短,术中出血量较多(P<0.05)。两组术中淋巴结清扫数量、切除肠管长度、术后5年生存率相比,差异均无统计学意义(P>0.05)。NOTES组术后6 h、12 h、1 d、2 d视觉模拟评分(VAS)均比传统组低(P<0.05),术后并发症总发生率较传统组低(7.7% VS. 21.8%),差异有统计学意义(P<0.05)。

结论

经自然腔道内镜手术治疗乙状结肠癌和高位直肠癌可减少对机体的创伤,缓解其疼痛情况,降低术后并发症风险,并有助于缩短术后恢复时间。

Objective

Comparison of the 5-year follow-up results of natural orifice transluminal endoscopic surgery(NOTES)with traditional laparoscopic minimally invasive surgery for sigmoid colon cancer and high rectal cancer.

Methods

The clinical data of 107 patients with sigmoid colon cancer and high rectal cancer from May 2013 to May 2015 was divided into NOTES group(52 cases)and traditional group(55 cases)according to different surgical procedures. SPSS 23.0 statistical analysis software was used. Perioperative indicators are represented by(

xˉ
±s),independent sample t-test was used. Complications and survival rates were tested by χ2 test;Kaplan-meier test was used to analyze and compare the two groups of progression-free survival Period. P<0.05 was considered statistically significant.

Results

Compared with the traditional group,the NOTES group had a longer operation time,shorter postoperative exhaust time and hospital stay,and more intraoperative blood loss(P<0.05). There was no statistically significant difference in the number of lymph node dissections,length of bowel resection,and 5-year survival rate after surgery between the two groups(P>0.05). The scores of VAS at 6 h,12 h,1 d,and 2 d in the NOTES group were lower than those in the traditional group(P<0.05). The total incidence of postoperative complications in the NOTES group was lower than that in the traditional group(7.7% VS 21.8%)(P<0.05).

Conclusion

NOTES for the treatment of sigmoid colon cancer and high rectal cancer can reduce the trauma to the body,relieve the pain,reduce the risk of postoperative complications,and help shorten postoperative recovery time.

表1 107例乙状结肠癌和高位直肠癌患者不同术式两组基线资料比较(
xˉ
±s
表2 107例乙状结肠癌和高位直肠癌患者不同术式两组手术相关指标比较(
xˉ
±s
表3 107例乙状结肠癌和高位直肠癌患者不同术式两组术后VAS比较(
xˉ
±s
表4 107例乙状结肠癌和高位直肠癌患者不同手术方式两组患者术后并发症情况比较(例)
[1]
姚永良,余凤,杨珮. 腹腔镜下全系膜切除的结肠癌根治术对患者近远期预后的影响[J/CD]. 中华普外科手术学杂志(电子版)201913(6):622-624.
[2]
廖梓群,陈维荣,方蓉,等. 改良三角吻合技术的完全腹腔镜乙状结肠癌根治术[J]. 中国微创外科杂志201919(10):903-906.
[3]
高庚妹,刘东宁,李太原. 腹部无切口经阴道取出标本的机器人高位直肠癌根治术近期疗效分析[J]. 中华胃肠外科杂志201922(12):1124-1130.
[4]
Yang SS,,Im YC. Severe abdominopelvic actinomycosis with colon perforation and hepatic involvement mimicking advanced sigmoid colon cancer with hepatic metastasis:a case study[J]. BMC Surgery201818(1):51.
[5]
中华人民共和国国家卫生和计划生育委员会. 结肠癌规范化诊疗指南(试行)[J/CD]. 中国医学前沿杂志(电子版)20135(8):50-55.
[6]
杨澎,朱宇. 低位和中高位直肠癌手术方式、并发症及预后比较[J]. 实用肿瘤杂志201934(3):245-248.
[7]
Kitade H,,Ebi H,,Hokkoku K,et al. Successful Long-Term Treatment with Intermittent Oxaliplatin Administration for Recurrent Sigmoid Colon Cancer without Developing Neuropathy[J]. Gan To Kagaku Ryoho201845(7):1113-1116.
[8]
秦颖,张海涛,庄树彤,等. 经肛肠减压后3D腹腔镜根治术治疗梗阻性结肠癌的临床观察[J/CD]. 中华普外科手术学杂志(电子版)201913(4):421-423.
[9]
Hiroshi M,,Sotaro S,,Yutaro K,et al. Chemoradiotherapy-induced Changes in Mucinous Components in Rectal Cancer Tissue:Evaluation on High Iron Diamine-alcian Blue and Mucin 1 Staining[J]. Anticancer Res201838(8):4783-4787.
[10]
朱哲,傅传刚,周主青,等. 经直肠取出标本的全腹腔镜前切除术治疗T4a期高位直肠癌及乙状结肠癌的安全性分析[J]. 中华胃肠外科杂志201922(5):484-487.
[11]
Gao Y,,Wu N,,Zhao Z,et al. Image-guided high-dose-rate interstitial brachytherapy technique for locally recurrent rectal cancer in perineum[J]. J Contemp Brachytherapy201810(3):267-273.
[12]
伍海锐,孙武青,赵晓牧,等. 腹壁无切口手术治疗乙状结肠癌和高位直肠癌的临床疗效分析[J]. 中华普通外科杂志201833(10):839-841.
[13]
吴岭,张建生,冯福梅,等. 两种腹腔镜手术方案在乙状结肠癌患者中的疗效对比[J]. 中国内镜杂志201824(5):85-89.
[14]
Li J,,Wang Y,,Liu D,et al. Multidimensional analyses of the learning curve for single-incision plus one port laparoscopic surgery for sigmoid colon and upper rectal cancer[J].J Surg Oncol2018117(7):1386-1393.
[15]
丁轶人,宋军,江涌,等. 经自然腔道取标本手术在完全腹腔镜中高位直肠癌根治术中的应用体会[J]. 腹腔镜外科杂志201924(8):88-592.
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