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中华结直肠疾病电子杂志 ›› 2023, Vol. 12 ›› Issue (03) : 196 -199. doi: 10.3877/cma.j.issn.2095-3224.2023.03.004

NOSES专栏

电子结肠镜辅助经结肠取标本手术在结肠肿瘤中的临床应用分析
常远, 白杨, 王文秀, 孙振强, 周全博, 崔雯铭, 王玉行, 袁维堂, 胡军红()   
  1. 450052 郑州大学第一附属医院结直肠肛门外科
  • 收稿日期:2022-11-09 出版日期:2023-06-25
  • 通信作者: 胡军红
  • 基金资助:
    河南省医学科技攻关计划(联合共建)项目(LHGJ20190152); 河南省医学科技攻关计划(省部共建重点)项目(SBGJ202102121)

Application of colonoscope assisted transcolonic specimen extraction surgery in colonic neoplasms

Yuan Chang, Yang Bai, Wenxiu Wang, Zhenqiang Sun, Quanbo Zhou, Wenming Cui, Yuxing Wang, Weitang Yuan, Junhong Hu()   

  1. Department of Colorectal Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
  • Received:2022-11-09 Published:2023-06-25
  • Corresponding author: Junhong Hu
引用本文:

常远, 白杨, 王文秀, 孙振强, 周全博, 崔雯铭, 王玉行, 袁维堂, 胡军红. 电子结肠镜辅助经结肠取标本手术在结肠肿瘤中的临床应用分析[J/OL]. 中华结直肠疾病电子杂志, 2023, 12(03): 196-199.

Yuan Chang, Yang Bai, Wenxiu Wang, Zhenqiang Sun, Quanbo Zhou, Wenming Cui, Yuxing Wang, Weitang Yuan, Junhong Hu. Application of colonoscope assisted transcolonic specimen extraction surgery in colonic neoplasms[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(03): 196-199.

目的

分析电子结肠镜辅助经结肠NOSES患者的临床资料,总结临床诊疗经验,探讨经电子结肠镜取标本的临床可行性。

方法

回顾性分析郑州大学第一附属医院2016年1月至2022年5月收治的8例电子结肠镜辅助经结肠NOSES患者的临床资料、手术方式、病理和随访结果。

结果

8例患者的肿瘤全部完整切除,标本在电子结肠镜的帮助下均顺利通过肠道经肛门取出,中位手术时间为190(160,210)min。中位术中出血量为60(40,80)mL。术后第一天中位VAS疼痛评分为4(2,5)分。术后病理获取的中位淋巴结数目为13(12,14)枚。1例患者术后第四天出现肺部感染,1例患者术后第六天出现肠梗阻,均经保守治疗后恢复,无吻合口漏及腹腔感染发生。术后随访6~50个月,无种植、复发及死亡发生。

结论

电子结肠镜辅助经结肠NOSES手术是一种安全、可靠、有效的手术方法,具有较好的应用前景和临床价值。

Objective

We analyzed the clinical data of patients treated by colonoscope assisted transcolonic specimen extraction surgery, summarized the clinical treatment experience, and explored its clinical feasibility.

Methods

The clinical data, surgical methods, pathology, and follow-up results of 8 colonic neoplasm patients treated with transcolonic NOSES in the First Affiliated Hospital of Zhengzhou University from January 2016 to May 2022 were analyzed retrospectively.

Results

The tumors were completely resected in all 8 patients, and the specimens were successfully extracted through anus by colonoscope. The median operation time was 190 (160, 210) minutes. The median intraoperative blood loss was 60 (40, 80) mL. The median VAS pain score was 4 (2, 5) on the first day after operation. The median number of lymph nodes retrieved was 13 (12, 14). There was one case of pulmonary infection on the fourth day after operation, and one case of ileus on the sixth day after operation. Both recovered after conservative symptomatic treatment. No patient had anastomotic leakage and abdominal infection. Follow up for 6 to 50 months showed no implantation, recurrence, or death.

Conclusion

Colonoscope assisted transcolonic specimen extraction surgery is a safe, reliable and effective surgical method with excellent application prospects and clinical value.

图1 肿瘤根治性切除的双镜联合NOSES手术。1A:打开远端结肠;1B:结肠镜插入至远端结肠并打开圈套器;1C:圈套器收紧病变远端肠管;1D:通过结肠镜将标本从肛门取出;1E:腔内侧侧吻合
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