Huang Jintuan, Wu Jianchao, Fang Sifu, Huang Jinmei, Chen Weili, Shi Zhimin
Department of Gastrointestinal Surgery, The Affiliated Huizhou Hospital, Guangzhou Medical University, Huizhou, Guangdong, China.
Department of Gastrointestinal Surgery, Huizhou Third People's Hospital, Huizhou, Guangdong, China.
BMC Surg. 2025 Apr 7;25(1):142. doi: 10.1186/s12893-025-02837-5.
To analyze and compare the application and efficacy of side-to-side anastomosis and end-to-end anastomosis in natural orifice specimen extraction surgery (NOSES) NOSES operation for left colon cancer.
A retrospective analysis of 69 patients in our hospital from February 2018 to February 2022 who underwent NOSES for left colon tumors. The observation group was performed with side-to-side anastomosis (Overlap). For digestive tract reconstruction, the control group was anastomosed by end-to-end anastomosis; the intraoperative and postoperative conditions and complications were compared between the two groups.
There was no significant difference in operation time and intraoperative blood loss between the two groups (P > 0.05). However, the intraoperative anastomosis time in the observation group was significantly shorter than that in the control group (P < 0.001). Additionally, there was no significant difference in the time of first exhaustion, defecation time, degree of patency of defecation, frequency of defecation, postoperative hospital stays and postoperative pain between the two groups (P > 0.05). Furthermore, the overall incidence of postoperative complications did not show a significant difference (P > 0.05).
In the NOSES surgery of left colon cancer, both side-to-side anastomosis (Overlap) and end-to-end anastomosis yielded comparable intraoperative and postoperative conditions and complications, but the side-to-side anastomosis (Overlap) method was simpler operation-wise and had a shorter intraoperative anastomosis time. As such, this method is the preferred anastomosis method when NOSES for colorectal cancer is carried out in primary hospitals.
ChiCTR1900026104 (2019-09-21).
分析并比较侧侧吻合与端端吻合在左半结肠癌自然腔道标本取出手术（NOSES）中的应用及疗效。
回顾性分析2018年2月至2022年2月在我院接受左半结肠肿瘤NOSES手术的69例患者。观察组采用侧侧吻合（重叠法）进行消化道重建，对照组采用端端吻合；比较两组患者的术中及术后情况和并发症。
两组患者手术时间和术中出血量比较，差异无统计学意义（P＞0.05）。然而，观察组术中吻合时间明显短于对照组（P＜0.001）。此外，两组患者首次排气时间、排便时间、排便通畅程度、排便频率、术后住院时间和术后疼痛程度比较，差异无统计学意义（P＞0.05）。而且，术后并发症总发生率比较，差异无统计学意义（P＞0.05）。
在左半结肠癌NOSES手术中，侧侧吻合（重叠法）和端端吻合的术中及术后情况和并发症相当，但侧侧吻合（重叠法）手术操作更简单，术中吻合时间更短。因此，在基层医院行结直肠癌NOSES手术时，该方法是首选的吻合方法。
ChiCTR1900026104（2019-09-21）。
