目的 比较腹腔镜下NOSES手术与小切口手术治疗结直肠癌的效果及对血清GAS、MTL水平的影响.方法 回顾性研究方式,选取结直肠癌46例,其中采用腹腔镜下NOSES手术治疗的患者23例纳入NOSES组,采用小切口手术治疗的患者23例纳入小切口组.统计2组疗效、术后疼痛及GAS、MTL水平.结果 NOSES组患者手术时间长于小切口组,NOSES组腹部切口总长小于小切口组(t=6.034,P＜0.001;t=17.089,P＜0.001).NOSES组首次排便时间、首次排气时间、首次下地活动时间均短于小切口组(t=3.727,P=0.001;t=4.048,P＜0.001;t=3.354,P=0.002)..2组MSP、RRP水平比较,差异无统计学意义(P＞0.05);2组GAS、MTL水平比较,差异具有统计学意义(t=2.792,P=0.008;t=3.503,P=0.001).NOSES组术后24 h VAS评分显著低于小切口组(t=8.404,P＜0.001).结论 腹腔镜下NOSES手术治疗结直肠癌,患者术后疼痛更轻,且手术对其胃肠功能产生的影响不明显,值得推广.
The Effect of Laparoscopic NOSES Surgery in the Treatment of Colorectal Cancer and its Effect on Postoperative Pain and Serum GAS and MTL Levels
Objective To compare the efficacy of laparoscopic NOSES surgery and small incision surgery in the treat-ment of colorectal cancer and their effects on serum GAS and MTL levels.Methods A retrospective study was conducted in 46 patients with colorectal cancer,of which 23 patients with laparoscopic NOSES surgery were included in the NOSES group and 23 patients with small-incision surgery were included in the small-incision group.The therapeutic effect,postoperative pain,GAS and MTL levels of the 2 groups were analyzed.Results The NOSES group had longer operation time than the small incision group,and the total length of abdominal incision in the NOSES group was smaller than that in the small incision group(t=6.034,P＜0.001;t=17.089,P＜0.001).The NOSES group has shorter first defecation time,first exhaust time,and first ground movement time than the small noses group(t=3.727,P=0.001;t=4.048,P＜0.001;t=3.354,P=0.002).The levels of MSP and RRP were compared between the two groups,P＞0.05;The comparison of GAS and MTL levels between the 2 groups showed statisti-cally significant differences(t=2.792,P=0.008;t=3.503,P=0.001).The NOSES group's 24 h VAS scores were significantly lower than those of the small incision group(t=8.404,P＜0.001).Conclusion Laparoscopic NOSES surgery in the treatment of colorectal cancer have less pain and no obvious effect on gastrointestinal function,which is worth promoting.
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