外科理论与实践 ›› 2021, Vol. 26 ›› Issue (04): 343-347.doi: 10.16139/j.1007-9610.2021.04.012

• 论著 • 上一篇    下一篇

腹部无辅助切口经阴道拖出标本的腹腔镜右半结肠癌根治术近期疗效对照研究

庄孟, 胡茜玥, 王锡山()   

  1. 国家癌症中心 国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院结直肠外科,北京 100021
  • 收稿日期:2021-05-26 出版日期:2021-07-25 发布日期:2022-08-02
  • 通讯作者: 王锡山 E-mail:wxshan1208@126.com

A comparative study of short-term outcomes of laparoscopic right hemicolectomy with transvaginal specimen extraction without abdominal incisions for radical resection of colon cancer

ZHUANG Meng, HU Xiyue, WANG Xishan()   

  1. Department of Colorectal Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China
  • Received:2021-05-26 Online:2021-07-25 Published:2022-08-02
  • Contact: WANG Xishan E-mail:wxshan1208@126.com

摘要:

目的:通过对比经腹部切口取标本的右半结肠癌手术,探究腹部无辅助切口经阴道拖出标本的完全腹腔镜右半结肠癌根治术(CRC-NOSES Ⅷ式 A法)的近期疗效。方法:分析29例经腹部切口取标本(经腹部组)与29例经阴道拖出标本(经阴道组)的完全腹腔镜右半结肠癌根治术的临床资料。对比两组病人的术前临床特征、术中情况和术后并发症、女性性功能评分,以此来对比两种取标本方式对病人的影响。结果:两组病人术中出血量、术后发热、术后出血、肠梗阻、吻合口漏等并发症发生差异无统计学意义。相对经腹部组,经阴道组病人手术时间较长 [(151.52±33.73) min比(179.59±47.02) min, P=0.012 0],但术后住院时间缩短(7.14 d比6.07 d, P=0.013 0),术后女性性生活恢复较快,腹部瘢痕影响小,术后女性性功能评分差异无统计学意义。结论:与常规经腹部切口取标本的腹腔镜右半结肠癌根治术相比,规范的CRC-NOSES Ⅷ式 A法安全、可行。经阴道组病人对瘢痕感知较弱、性生活恢复较快。

关键词: 右半结肠癌, 经阴道取标本, 经自然腔道取标本, 女性性功能指数

Abstract:

Objective To study the short-term outcomes of laparoscopic right hemicolectomy with transvaginal specimen extraction without abdominal incisions(CRC-NOSES Ⅷ A) for radical resection of colon cancer comparing with laparoscopic right hemicolectomy with transabdominal specimen extraction. Methods Clinical data of the patients with complete laparoscopic right hemicolectomy including 29 cases in transvaginal group and 29 cases in transabdominal group were collected. Comparision between two groups was done for preoperative clinical features, intraoperative indexes, post-operative complications, female sexual function score to charify the impact of the two methods of specimen removal on patients. Results There were no significant differences in intraoperative blood loss, fever and bleeding after operation, intestinal obstruction, anastomotic leakage and other postoperative complications between two groups. Compared with transabdominal group, operative time prolonged [(151.52±33.73) min vs. (179.59±47.02) min, P=0.012 0] and postoperative hospital stay decreased (7.14 d vs. 6.07 d, P=0.013 0) in transvaginal group. The female sexual activity recovered more quickly with less discomfort caused by the scar in transvaginal group and there was no statistical difference in postoperative female sexual function score between two groups. Conclusions CRC-NOSES Ⅷ A could be safe and feasible when compared with conventional laparoscopic hemicolectomy with transabdominal specimen extraction for radical resection of colon cancer. The patients in transvaginal group had less sensation of scars and faster recovery of sexual activity.

Key words: Right colon cancer, Transvaginal specimen extraction, Natural orifice specimen extraction, Female sexual function index

中图分类号: