摘要
目的探讨腹腔镜结肠次全切除术联合经自然腔道取标本手术(natural orifice specimen extraction surgery,NOSES)治疗结肠慢传输型便秘的可行性。方法2017年11月~2020年1月行腹腔镜结肠次全切除术联合NOSES治疗17例结肠慢传输型便秘,采用六孔法,按顺时针方向依次完成回盲部、肝区、脾曲、乙状结肠和直肠的游离,不重复移动设备和变换术者站位,经肛门取标本。结果17例手术均顺利完成。手术时间(192.2±16.7)min;出血量(35.3±6.8)ml。术后排气时间(2.1±1.2)d;术后排便时间(4.1±2.6)d。发生并发症3例,无严重并发症。术前便秘症状评分(15.7±1.8)分,术后1年评分(3.6±1.6)分,差异有统计学意义(t=23.612,P=0.000)。结论腹腔镜结肠次全切除术联合NOSES治疗结肠慢传输型便秘可行。
Objective To investigate the feasibility of the laparoscopic subtotal colectomy with natural orifice specimen extraction surgery(NOSES)for slow transit constipation.Methods We reported 17 patients with slow transit constipation who underwent laparoscopic subtotal colectomy with NOSES from November 2017 to January 2020 in our hospital.We designed 6 trocars on the abdominal wall.We separated the ileocecum,hepatic flexure of colon,splentic flexure of colon,sigmoid colon and rectum in clockwise order.We didn’t need to move the facilities and change the operators’standing repeatedly,and extracted the specimen through anus.Results All the 17 operations were completed successfully.The operation time was(192.2±16.7)min,the blood loss volume was(35.3±6.8)ml,the postoperative exhaust time was(2.1±1.2)d,and the postoperative defecation time was(4.1±2.6)d.There were 3 patients who developed complications after surgery,without severe complications.The total scores of conspitation symptoms were(15.7±1.8)points in pre-operation and(3.6±1.6)points in post-operation after one year,with statistical significance(t=23.612,P=0.000).Conclusion The laparoscopic subtotal colectomy with NOSES is feasible for treating the patients with slow transit constipation.
作者
徐忠凯
薛意恒
刘国勤
Xu Zhongkai;Xue Yiheng;Liu Guoqin(Department of Gastrointestinal Surgery, Jinan Central Hospital Affiliated to Shandong University, Ji’nan 250013, China)
出处
《中国微创外科杂志》
CSCD
北大核心
2021年第6期549-552,共4页
Chinese Journal of Minimally Invasive Surgery
