切换至 "中华医学电子期刊资源库"
高级检索
中华结直肠疾病电子杂志

中华结直肠疾病电子杂志 ›› 2020, Vol. 09 ›› Issue (06) : 610 -616. doi: 10.3877/cma.j.issn.2095-3224.2020.06.013

所属专题： 经自然腔道取标本手术学； 文献；

综述

结直肠肿瘤经自然腔道取标本手术的研究进展
王赫1, 刘志鹏1, 燕东1, 史新龙1, 王涛1, 杜斌斌1, 张维胜1, 杨熊飞1,†()   
  1. 1. 730000　兰州，甘肃省人民医院肛肠科
  • 收稿日期:2020-04-23 出版日期:2020-12-25
  • 通信作者: 杨熊飞
  • 基金资助:
    甘肃省青年科技基金(No. 17JR5RA031); 甘肃省自然科学基金(No. 18JR3RA055); 甘肃省人民医院院内科研基金(No. 18GSSY1-2); 甘肃省人民医院院内青年项目(No. 20GSSY4-9)

The application progress of NOSES in surgery of colorectal cancer

He Wang1, Zhipeng Liu1, Dong Yan1, Xinlong Shi1, Tao Wang1, Binbin Du1, Weisheng Zhang1, Xiongfei Yang1,†()   

  1. 1. Department of Colorectal Surgery, Gansu Provincial Hospital, Lanzhou 730000, China
  • Received:2020-04-23 Published:2020-12-25
  • Corresponding author: Xiongfei Yang
  • About author:
    Corresponding author: Yang Xiongfei, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

王赫, 刘志鹏, 燕东, 史新龙, 王涛, 杜斌斌, 张维胜, 杨熊飞. 结直肠肿瘤经自然腔道取标本手术的研究进展[J]. 中华结直肠疾病电子杂志, 2020, 09(06): 610-616.

He Wang, Zhipeng Liu, Dong Yan, Xinlong Shi, Tao Wang, Binbin Du, Weisheng Zhang, Xiongfei Yang. The application progress of NOSES in surgery of colorectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2020, 09(06): 610-616.

我国结直肠癌发病率和死亡率逐年增长，手术切除仍是最有效治疗方式。近年来，腹腔镜技术的广泛应用保障了患者最大利益，与开腹手术相比，减少了手术创伤，缩短了住院时间，有利于患者术后快速康复。然而，传统腹腔镜结直肠癌手术需要在腹壁建立辅助切口来取出标本，这不利于减少患者术后切口相关并发症发生的风险，也对患者术后镇痛和腹壁美容效果带来负面影响。经自然腔道取标本手术（NOSES）在传统腹腔镜手术基础上创造性地提出通过人体自然腔道取出标本这一理念，在优化微创技术的同时避免了腹壁切口。本文现就结直肠肿瘤经自然腔道取标本手术的研究进展作一综述。

关键词: 结直肠肿瘤, 经自然腔道取标本手术, 辅助切口

Incidence and mortality of colorectal cancer in China are increasing year by year, and surgical resection is still the most effective treatment for the disease. In recent years, the extensive application of laparoscopic surgery has ensured the best interests of patients. Compared with open surgery, it reduces surgical trauma, shortens hospital stay, and is conducive for postoperative recovery of patients. However, traditional laparoscopic colorectal cancer surgery requires the establishment of an auxiliary incision in the abdominal wall to remove specimens, which is not conducive to reducing the risk of postoperative incision-related complications after surgery, and also has a negative impact on postoperative analgesia and abdominal wall cosmetic effects of patients. Natural orifice specimen extraction surgery (NOSES) creatively puts forward the idea of taking out specimens through the natural lumen of human body on the basis of traditional endoscopic surgery, which avoids abdominal wall incision while optimizing minimally invasive technology. This article reviews the application progress of NOSES in surgery of colorectal cancer.

Key words: Colorectal neoplasms, Natural orifice specimen extraction surgery (NOSES), Auxiliary incision
[1]
郑荣寿. 2015年中国恶性肿瘤流行情况分析[J].中华肿瘤杂志, 2019, 41(1): 19-28.
[2]
Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy) [J]. Surg Laparosc Endosc, 1991, 1(3): 144-150.
[3]
Bedirli A, Salman B, Yuksel O. Laparoscopic versus open surgery for colorectal cancer: a retrospective analysis of 163 patients in a single institution [J]. Minim Invasive Surg, 2014, 2014: 530314.
[4]
崔雪阳，邢承忠. 液体活检在结直肠癌领域的研究及应用现状[J]. 实用肿瘤学杂志, 2018, 32(4): 367-370.
[5]
郑晖. 结直肠癌患者手术部位切口感染的危险因素分析 [D]. 福州: 福建医科大学, 2014.
[6]
Kalloo AN, Singh VK, Jagannath SB, et al. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity [J]. Gastrointest Endosc, 2004, 60(1): 114-117.
[7]
Marescaux J, Dallemagne B, Perretta S, et al. Surgery without scars: report of transluminal cholecystectomy in a human being [J]. Arch Surg, 2007, 142(9): 823-826; discussion 6-7.
[8]
Halim I, Tavakkolizadeh A. NOTES: The next surgical revolution? [J]. Int J Surg, 2008, 6(4): 273-276.
[9]
Person B, Vivas DA, Wexner SD. Totally laparoscopic low anterior resection with transperineal handsewn colonic J-pouch anal anastomosis for low rectal cancer [J]. Surg Endosc, 2006, 20(4): 700-702.
[10]
Whiteford MH, Denk PM, Swanstrom LL. Feasibility of radical sigmoid colectomy performed as natural orifice translumenal endoscopic surgery (NOTES) using transanal endoscopic microsurgery [J]. Surg Endosc, 2007, 21(10): 1870-1874.
[11]
中国NOSES联盟，中国医师协会结直肠肿瘤专业委员会NOSES专委会. 结直肠肿瘤经自然腔道取标本手术专家共识(2019版)[J/CD]. 中华结直肠疾病电子杂志, 2019, 8(4): 336-342.
[12]
王锡山. 结直肠肿瘤NOSES术关键问题的思考与探索[J/CD]. 中华结直肠疾病电子杂志, 2018, 7(4): 315:319.
[13]
Ma B, Huang XZ, Gao P, et al. Laparoscopic resection with natural orifice specimen extraction versus conventional laparoscopy for colorectal disease: a meta-analysis [J]. Int J Colorectal Dis, 2015, 30(11): 1479-1488.
[14]
Park JS, Kang H, Park SY, et al. Long-term outcomes after natural orifice specimen extraction versus conventional laparoscopy-assisted surgery for rectal cancer: a matched case-control study [J]. Ann Surg Treat Res, 2018, 94(1): 26-35.
[15]
Minjares-granillo RO, Dimas BA, Lefave JJ, et al. Robotic left-sided colorectal resection with natural orifice Intracorporeal anastomosis with extraction of specimen: The NICE procedure. A pilot study of consecutive cases [J]. Am J Surg, 2019, 217(4): 670-676.
[16]
Efetov SK, Tulina IA, Kim VD, et al. Natural orifice specimen extraction (NOSE) surgery with rectal eversion and total extra-abdominal resection [J]. Tech Coloproctol, 2019, 23(9): 899-902.
[17]
Zhou S, Wang X, Zhao C, et al. Comparison of short-term and survival outcomes for transanal natural orifice specimen extraction with conventional mini-laparotomy after laparoscopic anterior resection for colorectal cancer [J]. Cancer Manag Res, 2019, 11: 5939-5948.
[18]
Saad S, Schmischke D, Martin C, et al. Hybrid laparoscopic colectomy with transluminal colonoscopic specimen extraction--a step toward natural orifice surgery [J]. Endoscopy, 2010, 42 (Suppl 2): E346-347.
[19]
Eshuis EJ, Voermans RP, Stokkers PC, et al. Laparoscopic resection with transcolonic specimen extraction for ileocaecal Crohn's disease [J]. Br J Surg, 2010, 97(4): 569-574.
[20]
Wolthuis AM, Meuleman C, Tomassetti C, et al. Laparoscopic sigmoid resection with transrectal specimen extraction: a novel technique for the treatment of bowel endometriosis [J]. Hum Reprod, 2011, 26(6): 1348-1355.
[21]
Zhou S, Wang X, Zhao C, et al. Can transanal natural orifice specimen extraction after laparoscopic anterior resection for colorectal cancer reduce the inflammatory response? [J]. J Gastroenterol Hepatol, 2019, 34(6): 1016-1022.
[22]
Leroy J, Costantino F, Cahill RA, et al. Laparoscopic resection with transanal specimen extraction for sigmoid diverticulitis [J]. Br J Surg, 2011, 98(9): 1327-1334.
[23]
Costantino FA, Diana M, Wall J, et al. Prospective evaluation of peritoneal fluid contamination following transabdominal vs.transanal specimen extraction in laparoscopic left-sided colorectal resections [J]. Surg Endosc, 2012, 26(6): 1495-1500.
[24]
Christoforidis D, Clerc D, Demartines N. Transrectal specimen extraction after laparoscopic left colectomy: a case-matched study [J]. Colorectal Dis, 2013, 15(3): 347-353.
[25]
Guan X, Liu Z, Longo A, et al. International consensus on natural orifice specimen extraction surgery (NOSES) for colorectal cancer [J]. Gastroenterol Rep (Oxf), 2019, 7(1): 24-31.
[26]
Tarta C, Bishawi M, Bergamaschi R. Intracorporeal ileocolic anastomosis: a review [J]. Tech Coloproctol, 2013, 17(5): 479-485.
[27]
陈思敬，綦小蓉，王亚雯,等. 经阴道自然腔道内镜及传统腹腔镜手术治疗卵巢囊肿的临床对比分析[J/CD]. 中华腔镜外科杂志(电子版), 2019, 12(2): 86-91.
[28]
Tan CN, Chong CS, Fong YF, et al. Laparoscopic anterior resection with transvaginal specimen extraction (TVSE) for colorectal cancer and concomitant total hysterectomy and bilateral salpingo-oophrectomy (THBSO): a technical description [J]. Ann Surg Oncol, 2017, 24(2): 441.
[29]
Redwine DB, Koning M, Sharpe DR. Laparoscopically assisted transvaginal segmental resection of the rectosigmoid colon for endometriosis[J]. Fertil Steril, 1996, 65(1): 193-197.
[30]
Ghezzi F, Raio L, Mueller MD, et al. Vaginal extraction of pelvic masses following operative laparoscopy [J]. Surg Endosc, 2002, 16(12): 1691-1696.
[31]
Palanivelu C, Rangarajan M, Jategaonkar PA, et al. An innovative technique for colorectal specimen retrieval: a new era of "natural orifice specimen extraction" (N.O.S.E) [J]. Dis Colon Rectum, 2008, 51(7): 1120-1124.
[32]
Choi GS, Park IJ, Kang BM, et al. A novel approach of robotic-assisted anterior resection with transanal or transvaginal retrieval of the specimen for colorectal cancer [J]. Surg Endosc, 2009, 23(12): 2831-2835.
[33]
王锡山. 结直肠肿瘤类-NOTES术之现状及展望[J/CD].中华结直肠疾病电子杂志, 2015, 4(4): 11-6.
[34]
Zhang S, Jiang ZW, Wang G, et al. Robotic gastrectomy with transvaginal specimen extraction for female gastric cancer patients [J]. World J Gastroenterol, 2015, 21(47): 13332-13338.
[35]
Diana M, Perretta S, Wall J, et al. Transvaginal specimen extraction in colorectal surgery: current state of the art [J]. Colorectal Dis, 2011, 13(6): e104-111.
[36]
Franklin ME, Ramos R, Rosenthal D, et al. Laparoscopic colonic procedures [J]. World J Surg, 1993, 17(1): 51-56.
[37]
Darzi A, Super P, Guillou PJ, et al. Laparoscopic sigmoid colectomy: total laparoscopic approach [J]. Dis Colon Rectum, 1994, 37(3): 268-271.
[38]
Franklin ME, Kazantsev GB, Abrego D, et al. Laparoscopic surgery for stage III colon cancer: long-term follow-up[J]. Surg Endosc, 2000, 14(7): 612-616.
[39]
潘华峰. 手术机器人系统直肠癌切除术——经肛门拖出标本及手术机器人行吻合重建[J].中华胃肠外科杂志, 2012, 15(8): 807-809.
[40]
Franklin ME Jr, Liang S, Russek K. Integration of transanal specimen extraction into laparoscopic anterior resection with total mesorectal excision for rectal cancer: a consecutive series of 179 patients [J]. Surg Endosc, 2013, 27(1): 127-132.
[41]
Hisada M, Katsumata K, Ishizaki T, et al. Complete laparoscopic resection of the rectum using natural orifice specimen extraction [J]. World J Gastroenterol, 2014, 20(44): 16707-16713.
[42]
Wolthuis AM, Fieuws S, Van den bosch A, et al. Randomized clinical trial of laparoscopic colectomy with or without natural-orifice specimen extraction [J]. Br J Surg, 2015, 102(6): 630-637.
[43]
Liu RJ, Zhang CD, Fan YC, et al. Safety and oncological outcomes of laparoscopic NOSE surgery compared with conventional laparoscopic surgery for colorectal diseases: a meta-analysis [J]. Front Oncol, 2019, 9: 597.
[44]
朱水根. 腹腔镜直肠癌经肛拖出式切除术可行性分析 [J].中华普通外科杂志, 2014, 29(3): 216-217
[45]
Saurabh B, Chang SC, Ke TW, et al. Natural orifice specimen extraction with single stapling colorectal anastomosis for laparoscopic anterior resection: feasibility, outcomes, and technical considerations [J]. Dis Colon Rectum, 2017, 60(1): 43-50.
[46]
Gundogan E, Cicek E, Sumer F, et al. A case of vaginal recurrence following laparoscopic left-sided colon cancer resection combined with transvaginal specimen extraction [J]. J Minim Access Surg, 2019, 15(4): 345-347.
[47]
Ngu J, Wong AS. Transanal natural orifice specimen extraction in colorectal surgery: bacteriological and oncological concerns [J]. ANZ J Surg, 2016, 86(4): 299-302.
[48]
关旭，王贵玉，周主青,等. 79家医院718例结直肠肿瘤经自然腔道取标本手术回顾性研究[J/CD]. 中华结直肠疾病电子杂志, 2017, 6(6): 469:477.
[49]
Uccella S, Cromi A, Bogani G, et al. Transvaginal specimen extraction at laparoscopy without concomitant hysterectomy: our experience and systematic review of the literature [J]. J Minim Invasive Gynecol, 2013, 20(5): 583-590.
[50]
Hu JH, Li XW, Wang CY, et al. Short-term efficacy of natural orifice specimen extraction surgery for low rectal cancer [J]. World J Clin Cases, 2019, 7(2): 122-129.
[51]
Ng HI, Sun WQ, Zhao XM, et al. Outcomes of trans-anal natural orifice specimen extraction combined with laparoscopic anterior resection for sigmoid and rectal carcinoma: An observational study [J]. Medicine (Baltimore), 2018, 97(38): e12347.
[52]
Bokor A, Lukovich P, Csibi N, et al. Natural orifice specimen extraction during laparoscopic bowel resection for colorectal endometriosis: technique and outcome [J]. J Minim Invasive Gynecol, 2018, 25(6): 1065-1074.
[53]
丁海涛. 结直肠癌NOSE术对患者氧化应激、免疫功能及机体微炎症的影响 [J].中国现代手术学杂志, 2017, 21(1): 9-13.
[54]
Senft JD, Droscher T, Gath P, et al. Inflammatory response and peritoneal contamination after transrectal natural orifice specimen extraction (NOSE) versus mini-laparotomy: a porcine in vivo study [J]. Surg Endosc, 2018, 32(3): 1336-1343.
[55]
Izquierdo KM, Unal E, Marks JH. Natural orifice specimen extraction in colorectal surgery: patient selection and perspectives [J]. Clin Exp Gastroenterol, 2018, 11: 265-279.
[1] 康夏, 田浩, 钱进, 高源, 缪洪明, 齐晓伟. 骨织素抑制破骨细胞分化改善肿瘤骨转移中骨溶解的机制研究[J]. 中华乳腺病杂志(电子版), 2023, 17(06): 329-339.
[2] 代莉, 邓恢伟, 郭华静, 黄芙蓉. 术中持续输注艾司氯胺酮对腹腔镜结直肠癌手术患者术后睡眠质量的影响[J]. 中华普通外科学文献(电子版), 2023, 17(06): 408-412.
[3] 王得晨, 杨康, 杨自杰, 归明彬, 屈莲平, 张小凤, 高峰. 结直肠癌微卫星稳定状态和程序性死亡、吲哚胺2,3-双加氧酶关系的研究进展[J]. 中华普通外科学文献(电子版), 2023, 17(06): 462-465.
[4] 付佳, 肖海敏, 武曦, 冯涛, 师帅. 年龄校正查尔森合并症指数对腹腔镜结直肠癌围手术期并发症的预测价值[J]. 中华普通外科学文献(电子版), 2023, 17(05): 336-341.
[5] 唐旭, 韩冰, 刘威, 陈茹星. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 16-20.
[6] 张生军, 赵阿静, 李守博, 郝祥宏, 刘敏丽. 高糖通过HGF/c-met通路促进结直肠癌侵袭和迁移的实验研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 21-24.
[7] 李婷, 张琳. 血清脂肪酸代谢物及维生素D水平与结直肠癌发生的关系研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 661-665.
[8] 常剑, 邱峰, 毛郁琪. 摄食抑制因子-1与腹腔镜结直肠癌根治术后肝转移的关系分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 502-505.
[9] 王晓燕, 肖佑, 肖戈, 王真权. 老年结直肠癌肺转移CT特征及高危因素研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 506-509.
[10] 李博, 胡刚, 邱文龙, 汤坚强, 王锡山. 多功能吲哚菁绿近红外荧光血管成像技术在腹腔镜直肠癌经自然腔道取标本手术（NOSES Ⅳ式）中的应用（附视频）[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 524-528.
[11] 倪文凯, 齐翀, 许小丹, 周燮程, 殷庆章, 蔡元坤. 结直肠癌患者术后发生延迟性肠麻痹的影响因素分析[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 484-489.
[12] 范小彧, 孙司正, 鄂一民, 喻春钊. 梗阻性左半结肠癌不同手术治疗方案的选择应用[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 500-504.
[13] 关旭, 王锡山. 基于外科与免疫视角思考结直肠癌区域淋巴结处理的功与过[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 448-452.
[14] 顾睿祈, 方洪生, 蔡国响. 循环肿瘤DNA检测在结直肠癌诊治中的应用与进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 453-459.
[15] 张继新, 胡军红, 谢爽, 武祖印, 张春旭. 经阴道单孔腹腔镜阑尾切除术可行性及近期疗效分析[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 460-465.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号