腹腔镜经自然腔道取标本手术在老年高位直肠癌患者中的疗效分析OACSTPCD

Objective:To evaluate the efficacy of laparoscopic rectal surgery using natural orifice specimen extraction surgery compared with conventional laparoscopic rectal surgery in elder patients with upper rectal cancer.Methods:From Sep.2017 to Sep.2022,64 elderly patients with high rectal cancer were retrospectively selected and divided into control group and observation group.32 cases were enrolled in each group.Patients in both groups underwent laparoscopic radical resection of rectal cancer.The control group removed specimens through abdominal assisted incisions,while the observation group removed specimens through the anus.The amount of intraoperative bleeding,operation time,number of lymph nodes dissection,time to first exhaust after operation,pain score,time to first ambulation,and the incidence of postoprative complications were compared between the two groups.Results:There were no statistical differences in the baseline data between the two groups(P>0.05).There were no statistical differences between the two groups in the intraoperative blood loss,pathological grading,number of lymph node dissection,and the incidence of postoperative complications.The surgical margins were negative in both groups.The operation time of the observation group was longer than that of the control group,the pain score was less,the time of first flatus,the time of first ambulation,and postoperative hospital stay in the observation group were shorter than those in the control group(P<0.05).Conclusions:It is safe,effective and feasible to perform the laparoscopic radical re-section of upper rectal cancer via natural orifice specimen extraction surgery in the elderly patients.Compared with auxiliary incision,it has advantages in reducing postoperative pain and restoring gastrointestinal function.