NOSES A comparative study of functional end - end anastomosis and Overlap in radical left colon cancer

doi:10.3877/cma.j.issn.1674-3946.2023.01.017

Abstract

Abstract:

Objective

Comparison of clinical effect of functional end-to-end anastomosis and Overlap in radical resection of left heminoses colon cancer.

Methods

Clinical data of 78 patients who undergo radical NOSES left half colon cancer from January 2016 to January 2021 are retrospectively analyzed，and divided into two groups according to different ways of intraoperative digestive tract reconstruction. 38 cases of Overlap are included in Overlap group，and 40 cases of FEEA are included in FEEA group. SPSS 22.0 software was used to analyze clinical data. Postoperative complications and other statistical data were represented by［n（%）］. χ² test was used for comparison between groups. Measurement data such as perioperative indexes and postoperative serum nutritional indexes were represented by（

x ˉ

±s），and t test was used for comparison between groups. P<0.05 for the difference was statistically significant.

Results

All patients in both groups successfully completed radical NOSES left colon cancer. Operation time and anastomosis time in Overlap group were significantly longer than those in FEEA group；first postoperative exhaust time，hospital stay and hospital cost were significantly better than those in FEEA group（P<0.05）. There was no significant difference in serum nutritional indexes between 2 groups before and 7 days after surgery（P>0.05）. Serum albumin（ALB），hemoglobin（Hb）and total serum protein（TP）in 3 months after operation of Overlap group were significantly higher than those in FEEA group（P<0.05）. There was no significant difference in the total incidence of postoperative complications between 2 groups（P>0.05）.

Conclusion

NOSES left hemipelagic colon cancer Overlap can promote postoperative intestinal function recovery，improve long-term nutritional status，and is of great significance for promoting postoperative rehabilitation and reducing hospitalization costs.

Key words: Colonic Neoplasms, Colectomy, Natural Orifice Specimen Extraction Surgery, Functional end-to-end Anastomosis

Yong Zhen, Chao Zhang, Zunshu Zhang, Tao Sun. NOSES A comparative study of functional end - end anastomosis and Overlap in radical left colon cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(01): 69-72.

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References 16

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组别	例	性别	年龄(岁)	BMI(kg/m²)
组别	例	男/女	年龄(岁)	BMI(kg/m²)
Overlap组	38	18/20	59.6±7.3	22.7±2.4
FEEA组	40	19/21	60.4±7.9	22.4±2.2
χ²/t/Z值		0.000	-0.464	0.576
P值		0.991	0.644	0.566
组别	例	肿瘤直径 (cm)	肿瘤部位	TNM分期
组别	例	肿瘤直径 (cm)	a/b/c	Ⅰ/Ⅱ/Ⅲ
Overlap组	38	3.2±1.3	18/11/9	10/17/11
FEEA组	40	3.3±1.4	20/13/7	11/21/8
χ²/t/Z值		-0.326	-0.435	-0.612
P值		0.745	0.664	0.540

组别	例	性别	年龄(岁)	BMI(kg/m²)
组别	例	男/女	年龄(岁)	BMI(kg/m²)
Overlap组	38	18/20	59.6±7.3	22.7±2.4
FEEA组	40	19/21	60.4±7.9	22.4±2.2
χ²/t/Z值		0.000	-0.464	0.576
P值		0.991	0.644	0.566
组别	例	肿瘤直径 (cm)	肿瘤部位	TNM分期
组别	例	肿瘤直径 (cm)	a/b/c	Ⅰ/Ⅱ/Ⅲ
Overlap组	38	3.2±1.3	18/11/9	10/17/11
FEEA组	40	3.3±1.4	20/13/7	11/21/8
χ²/t/Z值		-0.326	-0.435	-0.612
P值		0.745	0.664	0.540

组别	例	手术时间 (min)	吻合时间 (min）	术中出血量(ml)
Overlap组	38	206.8±37.2	39.6±12.6	43.1±11.3
FEEA组	40	189.6±29.4	29.1±11.3	46.1±11.7
t值		3.896	3.879	-1.151
P值		0.000	0.000	0.253
组别	例	淋巴结清扫数(枚)	首次排气时间(d)	住院时间(d)	住院费用 (万元)
Overlap组	38	18.6±3.1	2.7±1.1	9.2±2.8	2.3±0.3
FEEA组	40	18.4±2.9	3.3±1.5	10.8±3.6	2.6±0.6
t值		0.294	-2.006	-2.183	2.770
P值		0.769	0.048	0.032	0.007

组别	例	手术时间 (min)	吻合时间 (min）	术中出血量(ml)
Overlap组	38	206.8±37.2	39.6±12.6	43.1±11.3
FEEA组	40	189.6±29.4	29.1±11.3	46.1±11.7
t值		3.896	3.879	-1.151
P值		0.000	0.000	0.253
组别	例	淋巴结清扫数(枚)	首次排气时间(d)	住院时间(d)	住院费用 (万元)
Overlap组	38	18.6±3.1	2.7±1.1	9.2±2.8	2.3±0.3
FEEA组	40	18.4±2.9	3.3±1.5	10.8±3.6	2.6±0.6
t值		0.294	-2.006	-2.183	2.770
P值		0.769	0.048	0.032	0.007

组别	例	时间	ALB(g/L)	Hb(g/L)	TP(mg/L)
Overlap组	38	术前	38.3±3.5	118.6±20.1	62.1±7.7
		术后7 d	31.6±2.7	90.3±10.8	52.4±4.2
		术后90 d	37.5±3.2^a	101.2±12.4^a	59.3±5.2^a
FEEA组	40	术前	38.6±3.3	117.9±18.8	61.9±7.6
		术后7 d	31.8±2.6	89.6±10.1	51.5±4.3
		术后90 d	36.1±2.4	95.3±11.3	56.3±4.6

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