A Comparative Analysis Of The Clinical Effect Between The Traditional Laparoscopic Colorectal Resection And The NOSES Colorectal Resection

Objective:To evaluate the feasibility and safety of natural orifice specimen extraction surgery in radical resection of colorectal cancer.And to evaluate the clinical efficacy and advantages of natural orifice specimen extraction surgery.To provide a theoretical basis for the application of NOSES in colorectal cancer surgery.Methods:We retrospectively analyzed the data of all patients undergoing radical resection of colorectal cancer at Northern Jiangsu Province Hospital between July 2016 and February 2019.Based on strict inclusion and exclusion criteria,48 patients were selected for study grouping,and divided into two groups according to different surgical methods.One group was traditional laparoscopic colorectal resection(LACR),with a total of 21 cases;the other group was natural orifice specimen extraction surgery(NOSES),with a total of 27 cases.There was no difference in treatment and nursing between the two groups,and surgery followed the principle of radical tumor resection.All patients were treated by the same group of doctors and nurses.The preoperative,intraoperative and postoperative indexes of the two groups were observed and compared.Preoperative indicators are general information of the patient.Intraoperative indicators are mean operation time and mean intraoperative blood loss.The postoperative indexes were the time of the first exhaust,the first defecation,postoperative pathology,tumor size,the postoperative pain score,the time of hospitalization,the incidence of postoperative complications,incision length,cosmetic effect satisfaction and survival analysis.We used SPSS 19.0 statistical software to conduct independent t test for measurement variables,and used χ2 test for counting data,and used GraphPad Prism 7.04 software for survival analysis,P<0.05 was considered statistically.Results:1.There was no significant difference in age,gender,weight,BMI,anesthesia score,operation time and intraoperative bleeding between the two groups(P>0.05).2.The postoperative hospital stay,the time of the first postoperative exhaust in the NOSES group was significantly shorter than that in the LACR group(P<0.05).3.There was no significant difference in postoperative pathology,tumor size and the first defecation time between the two groups(P>0.05).4.The scores of pain in the first day and the third day after operation were lower in the NOSES group,the difference was statistically significant(P<0.001).5.There was no significant difference of postoperative complications between two groups(P>0.05).6.The length of incision was shorter and the satisfaction of cosmetology effect was higher in the NOSES group(P<0.001).7.There was no significant difference in the short-term survival rate between the two groups(P>0.05).Conclusion:It is safe and feasible to apply NOSES in radical resection of colorectal cancer.The application of NOSES in colorectal cancer patients is beneficial to the recovery after surgery.