Department of General Surgery, The First Affiliated Hospital of Nanchang University, No. 17 Yongwaizheng Street, Nanchang, 330006, Jiangxi Province, China.
BMC Surg. 2023 Nov 8;23(1):336. doi: 10.1186/s12893-023-02216-y.
With the development of minimally invasive technology, the trauma caused by surgery get smaller, At the same time, the specimen extraction surgery through the natural orifice is more favored by experts domestically and abroad, robotic surgery has further promoted the development of specimen extraction surgery through the natural orifice. The aim of current study is to compare the short-term outcomes of robotic-assisted natural orifice specimen extraction (NOSES ) and transabdominal specimen extraction(TRSE ) in median rectal cancer surgery.
From January 2020 to January 2023, 87 patients who underwent the NOSES or TRSE at the First Affiliated Hospital of Nanchang University were included in the study, 4 patients were excluded due to liver metastasis. Of these, 50 patients were in the TRSE and 33 patients in the NOSES. Short-term efficacy was compared in the two groups.
The NOSES group had less operation time (P < 0.001), faster recovery of gastrointestinal function (P < 0.001), shorter abdominal incisions (P < 0.001), lower pain scores(P < 0.001). lower Inflammatory indicators of the white blood cell count and C-reactive protein content at 1, 3, and 5 days after surgery (P < 0.001, P = 0.037). There were 9 complications in the NOSES group and 11 complications in the TRSE group(P = 0.583). However, there were no wound complications in the NOSES group. The number of postoperative hospital stays seems to be same in the two groups. And there was no significant difference in postoperative anus function (P = 0.591).
This study shows that NOSES and TRSE can achieve similar radical treatment effects, NOSES is a feasible and safe way to take specimens for rectal cancer surgery in accordance with the indication for NOSES.
随着微创技术的发展，手术创伤越来越小，同时，国内外专家更倾向于经自然腔道取标本的手术，机器人手术进一步促进了经自然腔道取标本手术的发展。本研究旨在比较机器人辅助经自然腔道取标本（NOSES）与经腹取标本（TRSE）在中低位直肠癌手术中的短期疗效。
回顾性分析 2020 年 1 月至 2023 年 1 月南昌大学第一附属医院行 NOSES 或 TRSE 的 87 例患者的临床资料，排除 4 例因肝转移而失访的患者，其中 50 例行 TRSE，33 例行 NOSES。比较两组患者的短期疗效。
NOSES 组手术时间更短（P<0.001），胃肠功能恢复更快（P<0.001），腹部切口更短（P<0.001），疼痛评分更低（P<0.001），术后第 1、3、5 天白细胞计数和 C 反应蛋白含量等炎症指标更低（P<0.001，P=0.037）。NOSES 组有 9 例并发症，TRSE 组有 11 例并发症（P=0.583），但 NOSES 组无切口相关并发症。两组术后住院时间无明显差异（P=0.591），术后肛门功能无明显差异（P=0.591）。
NOSES 和 TRSE 均可达到相似的根治效果，符合 NOSES 适应证的直肠癌患者可选择 NOSES 取标本。
