摘要
目的通过观察完全腹腔镜下经阴道取标本在老年女性中低位直肠癌手术操作过程和术后并发症发生情况,探讨该术式在老年女性直肠癌中应用的可行性及临床效果。方法纳入2017年1月至2018年4月陕西省人民医院普外一科符合经自然腔道取标本手术(NOSES)条件的5例老年女性中低位直肠癌患者,均成功实施了经阴道取标本手术,观察5例患者的术中情况及术后近期恢复情况及并发症发生情况。结果所有患者均按照预期目标完成手术,无中转其他手术方式,无吻合口瘘,无阴道溢液,无伤口感染,无肺部感染。1例89岁患者在术后12月时诊断12 mm戳孔疝并手术治疗。结论经阴道取标本在老年女性中低位直肠癌患者的应用安全有效、并未增加手术相关并发症、减少了腹壁切口对患者呼吸功能的影响,避免了切口相关并发症,符合术后快速康复的要求,可以在符合条件的患者中使用。
ObjectiveTo investigate the operation procedure and safety of trans-vagina specimen extraction for elderly female with mid-low rectal cancer. MethodsFrom January 2017 to April 2018, ？ve elderly female with mid-low rectal cancer who suffered from multiple medical comorbidities, were successfully implemented atural ori？ce specimen extraction surgery （NOSES） in Shanxi Provincial People′s Hospital. Intraoperative procedure of trans-vaginal specimen extraction and postoperative complications were observed. ResultsAll the patients completed the operative procedure without transferring to other operative methods. No anastomotic leakage, no leakage of vagina wound and abdominal wound, no pulmonary infection was observed. One 89-years old patient was diagnosed incision hernia at the wound of 12 mm trocar inserted in 12 months postoperatively. ConclusionTrans-vagina speciman extraction procedure can be applied safely and effectively in elderly female with vmid-low rectal cancer. This kind of NOSES technique does not increase complications related to the operation, reduces the incision in？uence on patients with respiratory dysfunction and avoid the incision related complications. Trans-vagina specimen extraction surgery should be used in eligible patients of elderly women with mid-low rectal cancer.
作者
邱健
刘瑞廷
张剑
王奔
王旭
刘力强
Qiu Jian;Liu Ruiting;Zhang Jian;Wang Ben;Wang Xu;Liu Liqiang(Department of General Surgery,Shanxi Provincial People′s Hospital,Xi′an 710068,China)
出处
《中华结直肠疾病电子杂志》
2018年第4期385-388,共4页
Chinese Journal of Colorectal Diseases(Electronic Edition)
基金
2017陕西省国际科技合作与交流计划面上项目(No.2017KW-046)
关键词
直肠肿瘤
经阴道拖出标本
老年女性
中低位直肠癌
经自然腔道取标本手术
Rectal neoplasms
Trans-vagina speciman extraction
Elderly female
Mid-low rectal cancer
Natural orifice specimen extraction surgery （NOSES）
