经自然腔道取标本手术治疗老年结直肠癌的短期疗效分析OACSTPCD

Objective:To compare the short-term clinical efficacy of natural orifice specimen extraction surgery(NOSES)and traditional laparoscopic surgery(CLS)in the treatment of elderly patients with colorectal cancer,and to evaluate the application value of NOSES in elderly patients with colorectal cancer.Methods:From Oct.2022 to Nov.2023,63 elderly patients with colorectal cancer diagnosed by colonoscopy and preoperative pathology who were scheduled for radical resection of middle and high rectal cancer and distal sigmoid colon cancer were selected and randomly divided into NOSES group(n=31)and CLS group(n=32).During the study,5 patients in the NOSES group and 6 patients in the CLS group were excluded.Finally,26 patients in both groups were included in the study.The clinical data of the two groups were collected and analyzed.Results:There were no significant differences in operation time,blood loss,number of lymph node dissection,bacterial culture results of peritoneal lavage fluid,postoperative white blood cell count,postoperative C-reactive protein level and incidence of complications between the two groups(P>0.05).The numerical rating scale pain scores in the NOSES group were lower than those in the CLS group on the 1st,2nd and 3rd day after operation(P<0.05).The first ambulation time,the first exhaust time and the postoperative hospital stay in the NOSES group were shorter than those in the CLS group(P<0.05),and the prealbumin in the NOSES group was higher than that in the CLS group 7 d after operation(P<0.05).Conclu-sions:The application of NOSES in elderly patients with colorectal cancer who meet the surgical indications can achieve the same safety as CLS.Compared with CLS,NOSES has the advantages of reducing postoperative pain,promoting early ambulation,promoting gastroin-testinal function recovery,accelerating nutritional recovery,and shortening hospital stay.NOSES is worthy of promotion in eligible elder-ly patients with colorectal cancer.