比较经阴道与经肛门自然腔道标本取出术（NOSE）在女性结直肠癌（CRC）腹腔镜根治术的临床效果。

回顾性分析2023年6月至2025年5月112例女性CRC患者的临床资料，根据不同NOSE分为阴道组（n=41，经阴道取出标本）和肛门组（n=71，经肛门取出标本），符合正态分布的计量资料用（±s）表示，采用独立样本t检验；计数资料采用χ²检验。P<0.05表示差异有统计学意义。

阴道组患者手术时间、术后住院时间、首次排气时间、首次排便时间及流质饮食开始时间均短于肛门组（P<0.05），两组患者术中出血量、肿瘤近、远端肠管切除长度、淋巴结清扫数目、并发症发生率比较差异无统计学意义（P>0.05）。术后3个月，两组患者女性性功能指数（FSFI）较术前均升高，盆底障碍影响简易问卷7（PFIQ-7）评分、盆腔脏器脱垂症状困扰量表20（PFID-20）评分较术前均下降（P<0.05），但两组间上述指标比较差异无统计学意义（P>0.05）。

腹腔镜CRC切除术中经阴道取出标本可在保证肿瘤根治效果与手术安全性的前提下，显著简化手术操作，加快术后胃肠功能及身体恢复，且不增加盆底功能损害或并发症风险，可作为女性CRC患者腹腔镜手术中一种高效、安全的标本取出方式。

To compare the clinical effects of transvaginal and transanal natural orifice specimen extraction surgery (NOSE) in laparoscopic radical resection of colorectal cancer (CRC) in women.

The clinical data of 112 female CRC patients from June 2023 to May 2025 were retrospectively analyzed. They were divided into the vaginal group (n=41, specimens removed through the vagina) and the anal group (n=71, specimens removed through the anus) based on different NOSE methods. The measurement data conforming to normal distribution were expressed as (±s), and independent sample t test was used; the count data were analyzed by χ² test. P<0.05 was considered statistically significant.

The operation time, postoperative hospital stay, time to first flatus, time to first defecation, and time to start liquid diet in the vaginal group were all shorter than those in the anal group (P<0.05). There were no statistically significant differences in intraoperative blood loss, lengths of proximal and distal resected intestinal segments, number of lymph nodes dissected, and complication rates between the two groups (P>0.05). Three months after surgery, the Female Sexual Function Index (FSFI) of both groups increased compared with that before surgery, and the Pelvic Floor Impact Questionnaire 7 (PFIQ-7) score and Pelvic Floor Distress Inventory 20 (PFID-20) score decreased compared with those before surgery (P<0.05), but there were no statistically significant differences in these indicators between the two groups (P>0.05).

Transvaginal specimen extraction during laparoscopic CRC resection can significantly simplify the surgical procedure, accelerate postoperative gastrointestinal function and physical recovery, without increasing the risk of pelvic floor dysfunction or complications, under the premise of ensuring the radical effect and surgical safety. It can be used as an efficient and safe specimen extraction method in laparoscopic surgery for female CRC patients.