Tao Fang, Liu Dong-Ning, He Peng-Hui, Luo Xin, Xu Chi-Ying, Li Tai-Yuan, Duan Jin-Yuan
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330052, Jiangxi Province, China.
Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330052, Jiangxi Province, China.
World J Gastrointest Surg. 2023 Oct 27;15(10):2142-2153. doi: 10.4240/wjgs.v15.i10.2142.
Robotic resection using the natural orifice specimen extraction surgery I-type F method (R-NOSES I-F) is a novel minimally invasive surgical strategy for the treatment of lower rectal cancer. However, the current literature on this method is limited to case reports, and further investigation into its safety and feasibility is warranted.
To evaluate the safety and feasibility of R-NOSES I-F for the treatment of low rectal cancer.
From September 2018 to February 2022, 206 patients diagnosed with low rectal cancer at First Affiliated Hospital of Nanchang University were included in this retrospective analysis. Of these patients, 22 underwent R-NOSES I-F surgery (R-NOSES I-F group) and 76 underwent conventional robotic-assisted low rectal cancer resection (RLRC group). Clinicopathological data of all patients were collected and analyzed. Postoperative outcomes and prognoses were compared between the two groups. Statistical analysis was performed using SPSS software.
Patients in the R-NOSES I-F group had a significantly lower visual analog score for pain on postoperative day 1 (1.7 ± 0.7 2.2 ± 0.6, = 0.003) and shorter postoperative anal venting time (2.7 ± 0.6 3.5 ± 0.7, < 0.001) than those in the RLRC group. There were no significant differences between the two groups in terms of sex, age, body mass index, tumor size, TNM stage, operative time, intraoperative bleeding, postoperative complications, or inflammatory response ( > 0.05). Postoperative anal and urinary functions, as assessed by Wexner, low anterior resection syndrome, and International Prostate Symptom Scale scores, were similar in both groups ( > 0.05). Long-term follow-up revealed no significant differences in the rates of local recurrence and distant metastasis between the two groups ( > 0.05).
R-NOSES I-F is a safe and effective minimally invasive procedure for the treatment of lower rectal cancer. It improves pain relief, promotes gastrointestinal function recovery, and helps avoid incision-related complications.
使用经自然腔道标本取出手术I型F法（R-NOSES I-F）进行机器人切除术是一种治疗低位直肠癌的新型微创手术策略。然而，目前关于该方法的文献仅限于病例报告，因此有必要进一步研究其安全性和可行性。
评估R-NOSES I-F治疗低位直肠癌的安全性和可行性。
2018年9月至2022年2月，南昌大学第一附属医院206例诊断为低位直肠癌的患者纳入本回顾性分析。其中，22例行R-NOSES I-F手术（R-NOSES I-F组），76例行传统机器人辅助低位直肠癌切除术（RLRC组）。收集并分析所有患者的临床病理资料。比较两组患者的术后结局和预后。使用SPSS软件进行统计分析。
R-NOSES I-F组患者术后第1天的视觉模拟疼痛评分显著低于RLRC组（1.7±0.7对2.2±0.6，P = 0.003），术后肛门排气时间也更短（2.7±0.6对3.5±0.7，P < 0.001）。两组在性别、年龄、体重指数、肿瘤大小、TNM分期、手术时间、术中出血、术后并发症或炎症反应方面无显著差异（P > 0.05）。根据Wexner、低位前切除综合征和国际前列腺症状评分评估，两组患者术后的肛门和排尿功能相似（P > 0.05）。长期随访显示，两组的局部复发率和远处转移率无显著差异（P > 0.05）。
R-NOSES I-F是一种治疗低位直肠癌的安全有效的微创手术。它能减轻疼痛，促进胃肠功能恢复，并有助于避免与切口相关的并发症。
