The application of trans-vagina specimen extraction surgery in elderly female with mid-low rectal cancer

doi:10.3877/cma.j.issn.2095-3224.2018.04.016

Abstract

Abstract:

Objective

To investigate the operation procedure and safety of trans-vagina specimen extraction for elderly female with mid-low rectal cancer.

Methods

From January 2017 to April 2018, five elderly female with mid-low rectal cancer who suffered from multiple medical comorbidities, were successfully implemented atural orifice specimen extraction surgery (NOSES) in Shanxi Provincial People′s Hospital. Intraoperative procedure of trans-vaginal specimen extraction and postoperative complications were observed.

Results

All 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.

Conclusion

Trans-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 influence 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.

Key words: Rectal neoplasms, Trans-vagina speciman extraction, Elderly female, Mid-low rectal cancer, Natural orifice specimen extraction surgery (NOSES)

Jian Qiu, Ruiting Liu, Jian Zhang, Ben Wang, Xu Wang, Liqiang Liu. The application of trans-vagina specimen extraction surgery in elderly female with mid-low rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2018, 07(04): 385-388.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhjzcjbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3224.2018.04.016

https://zhjzcjbdzzz.cma-cmc.com.cn/EN/Y2018/V07/I04/385

Figures/Tables 3

References 9

[1]	中国NOSES联盟, 中国医师协会结直肠肿瘤委员会NOSES专委会.结直肠肿瘤经自然腔道取标本手术专家共识(2017) [J/CD]. 中华结直肠疾病电子杂志, 2017, 6(4): 266-272.
[2]	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 resection [J]. Surg Endosc, 2012, 26(6): 1495-1500.
[3]	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.
[4]	Amin MB, Greene FL, Edge S, et al. AJCC cancer staging manual (ed 8^th Edition).New York: Springer: 2016.
[5]	Chen WQ, Sun K, Zheng RS, et al. Cancer incidence and mortality in china, 2014 [J]. Chin J Cancer Res, 2018, 30(1): 1-12.
[6]	Garcia-Granero E, Faiz O, MUÑOZ E, et al. Macroscopic assessment of mesorectal excision in rectal cancer: a useful tool for improving quality control in a multidisciplinary team [J]. Cancer, 2009, 115(15): 3400-3411.
[7]	徐永鹏, 刘正, 王贵玉, 等. 腹部无切口经直肠肛门外翻切除标本的低位直肠癌根治术11例 [J]. 肿瘤研究与临床, 2014, 26(12): 813-815.
[8]	Han FH, Hua LX, Zhao Z, et al. Transanal natural orifice specimen extraction for laparoscopic anterior resection in rectal cancer [J]. World J Gastroenterol, 2013, 19(43): 7751-7757.
[9]	王锡山.经自然腔道取标本手术: 结直肠肿瘤[M].北京: 人民卫生出版社, 2016: 116.

病例	年龄（岁）	肿瘤下缘距肛缘（cm）	肿瘤直径（cm）	病理分级	重要合并症	体重指数（BMI，kg/m²）
1	79	5	3.0	中分化腺癌	高血压	27.3
1	79	5	3.0	中分化腺癌	2型糖尿病	27.3
2	89	10	3.5	高分化腺癌	冠心病	26.7
					高血压
					腔隙性脑梗
3	82	7	4.0	高分化腺癌	慢性阻塞性肺疾病	25.0
3	82	7	4.0	高分化腺癌	肺动脉高压	25.0
4	83	8	2.5	高分化腺癌	冠心病	28.7
4	83	8	2.5	高分化腺癌	高血压	28.7
5	76	4	3.0	中分化腺癌	2型糖尿病	25.5

病例	年龄（岁）	肿瘤下缘距肛缘（cm）	肿瘤直径（cm）	病理分级	重要合并症	体重指数（BMI，kg/m²）
1	79	5	3.0	中分化腺癌	高血压	27.3
1	79	5	3.0	中分化腺癌	2型糖尿病	27.3
2	89	10	3.5	高分化腺癌	冠心病	26.7
					高血压
					腔隙性脑梗
3	82	7	4.0	高分化腺癌	慢性阻塞性肺疾病	25.0
3	82	7	4.0	高分化腺癌	肺动脉高压	25.0
4	83	8	2.5	高分化腺癌	冠心病	28.7
4	83	8	2.5	高分化腺癌	高血压	28.7
5	76	4	3.0	中分化腺癌	2型糖尿病	25.5

病例	1	2	3	4	5
pT分期	T2	T3	T3	T2	T3
pN分期	N0	N1	N1	N0	N0
pTNM分期	Ⅰ期	Ⅲb期	Ⅲb期	Ⅰ期	Ⅱa期

病例	1	2	3	4	5
pT分期	T2	T3	T3	T2	T3
pN分期	N0	N1	N1	N0	N0
pTNM分期	Ⅰ期	Ⅲb期	Ⅲb期	Ⅰ期	Ⅱa期

[1]	Xia Kang, Hao Tian, Jin Qian, Yuan Gao, Hongming Miao, Xiaowei Qi. Osteorin attenuates osteolysis during bone metastasis of cancers through inhibiting osteoclastogenesis [J]. Chinese Journal of Breast Disease(Electronic Edition), 2023, 17(06): 329-339.
[2]	Dechen Wang, Kang Yang, Zijie Yang, Mingbin Gui, Lianping Qu, Xiaofeng Zhang, Feng Gao. Progress of microsatellite stability state and PD-1/PD-L1/IDO in colorectal carcinoma [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(06): 462-465.
[3]	Xu Tang, Bing Han, Wei Liu, Ruxing Chen. Analysis of risk factors for metachronous liver metastases after radical colorectal cancer surgery and construction of a predictive model [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 16-20.
[4]	Shengjun Zhang, Ajing Zhao, Shoubo Li, Xianghong Hao, Minli Liu. An experimental study on the promotion of colorectal cancer invasion and migration by high glucose through HGF/c-met pathway [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 21-24.
[5]	Yanhui Zhang, Jiao Zhang, Zhixian Zhu. Effect of indwelling anal tube on anastomotic leakage after laparoscopic total mesangectomy after neoadjuvant chemoradiotherapy in patients with middle and low rectal cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 25-28.
[6]	Ting Li, Lin Zhang. Relationship between serum fatty acid metabolites and vitamin D levels and colorectal cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 661-665.
[7]	Zhenbao Fu, Wanlong Cao, Fuhong Liu. Clinical effect of double ileal stomy with different suture methods during laparoscopic low anterior resection of rectal cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 684-687.
[8]	Liang He, Songlin Wang, Yejiang Zhou. Comparative study on the effect of two prophylactic ileostomy in the treatment of ultra-low rectal cancer by laparoscopic ISR [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 697-700.
[9]	Xu Guan, Xishan Wang. Reflecting on the merits and demerits of regional lymph node management in colorectal cancer based on surgical and immune perspectives [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 448-452.
[10]	Ruiqi Gu, Hongsheng Fang, Guoxiang Cai. Application and progress of circulating tumor DNA detection technology in the diagnosis and treatment of colorectal cancer [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 453-459.
[11]	Yanjun Lu, Jian Ma, Pengyu Bai, Linghong Guo, Haiyi Liu, Bo Jiang, Wenqi Bai, Yixun Zhang. Clinical effect of Nano-carbon on 253 groups of lymph node dissection in laparoscopic radical resection of rectal cancer [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 473-477.
[12]	Wenkai Ni, Chong Qi, Xiaodan Xu, Xiecheng Zhou, Qingzhang Yin, Yuankun Cai. Analysis of influencing factors of prolonged postoperative ileus in patients with colorectal cancer after operation [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 484-489.
[13]	Xiaoyu Fan, Sizheng Sun, Yimin E, Chunzhao Yu. Different surgical options for obstructive left colon cancer [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 500-504.
[14]	Hongjie Yang, Zhichun Zhang, Yi Sun. Study progress in the diagnosis of lymph node metastasis of rectal cancer [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 512-518.
[15]	Huiying Ma, Xinling Fan, Shirui Tan, Jiayun Chen, Ying Cao, Yuan Xu, Jing Jin, Yuan Tang. Magnetic resonance linac for locally advanced rectal cancer: a preliminary experience [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 519-523.

Please choose a citation manager

Content to export