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Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:

2023 23

Page:

4372-4377

Research Field:

Publishing date:

Info

Title:

The efficacy analysis of laparoscopic right colon cancer radical resection transrectal specimen extraction without abdominal incision(NOSES Ⅷ B)(24) cases

Author(s):

LIU Chun¹; LI Wei¹; ZHANG Zhixue¹; GAO Fuchun¹; LI Xinyu²; ZHANG Caixia³; LIU Shuhong⁴

1.Department of General Surgery;3.Department of Medical Records;4.Department of Radiotherapy,Luanzhou People's Hospital,Hebei Luanzhou 063700,China;2.Department of Colorectal Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China.

Keywords:

natural orifice specimen extraction; ascending colon cancer; safety; efficacy analysis

PACS:

R735.3+5

DOI:

10.3969/j.issn.1672-4992.2023.23.014

Abstract:

Objective:To evaluate the safety and clinical efficacy of laparoscopic right colon cancer radical resection transrectal specimen extraction without abdominal incision(NOSES Ⅷ type B).Methods:From January 2017 to December 2021,the clinicopathological data of patients who underwent laparoscopic right colon cancer radical resection transvaginal specimen extraction without abdominal incision(NOSES Ⅷ type A) and NOSES Ⅷ type B in the Cancer Hospital of the Chinese Academy of Medical Sciences and Luanzhou People's Hospital were retrospectively collected and analyzed.The clinicopathological features,surgical conditions,postoperative recovery, postoperative complications,and postoperative recurrence and metastasis of the patients between two groups were compared.Results:A total of 81 patients were included in the study,including 57 patients who underwent NOSES Ⅷ type A and 24 patients who underwent NOSES Ⅷ type B.The proportion of male patients in the NOSES Ⅷ type B group was significantly higher than that in the NOSES Ⅷ type A group(91.7% vs 0,P＜0.001).There was no significant difference in the remaining baseline data between the two groups(P＞0.05).There was no significant difference between the average operation time［(176.6 vs 167.3)min,P=0.529］ and intraoperative blood loss［(35.5 vs 31.2)mL,P=0.733］ between the two groups.In addition,the visual analogue scale(VAS) scores on day 1(4.3 vs 4.5,P=0.852),day 3(4.0 vs 4.3,P=0.572) and day 5(2.5 vs 2.3,P=0.742) were similar between the two groups.There was no significant difference in postoperative complications between the two groups(14.0% vs 12.5%,P=0.854).The time to first flatus［(2.0 vs 1.8)days,P=0.893］ and postoperative hospital stay［(7.0 vs 6.8)days,P=0.904］ were similar between the two groups.In terms of pathology,there were no significant differences in the number of lymph nodes dissected［(24.6 vs 25.2)number,P=0.319］,specimen resection length［(32.1 vs 33.2)cm,P=0.395］,and tumor size［(3.3 vs 2.8)cm,P=0.195］ between the two groups.Within 3 months after surgery,patients in the NOSES Ⅷ type B group did not have complications related to rectotomy,such as rectal bleeding,rectal stricture,paresthesias,and pelvic abscess.During the follow-up period,a total of 6 patients in the NOSES Ⅷ type A group had local recurrence and distant metastasis,and a total of 2 patients in the NOSES Ⅷ type B group had distant metastases.In both groups,tumor recurrence and metastasis were not found in incision pelvic,rectal cavity and vagina.Conclusion:Laparoscopic right colon cancer radical resection transrectal specimen extraction without abdominal incision is safe and feasible,with short term advantages such as less trauma,faster recovery and less pain.Under the premise of strictly grasping the surgical indications and adhering to the principle of sterile tumor-free,this procedure does not increase the risk of tumor recurrence implantation,and can be carried out in young unmarried female patients or in male colon cancer patients with high tumor location.

References:

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Memo

Memo:

中国癌症基金会北京希望马拉松专项基金（编号：LC2019A30）

Common functions

Last Update: 2023-10-31