| BackgroundColorectal cancer is a common tumor of digestive tract,and its morbidity and mortality are increasing year by year in China and the world.According to the statistical analysis of the World Health Organization,the incidence of colorectal cancer is in the third place in the spectrum of malignant tumors worldwide,and its mortality is in the second place in the spectrum of malignant tumors.According to data released by the National Cancer Center,colorectal cancer is the fourth most common malignancy in China and the fifth most common cause of death among all malignancies.The middle and low rectal cancer was the main site of rectal cancer.Data show that the incidence and mortality of colorectal cancer in China are rising rapidly after the age of 50,and reach a peak at the age of 80.At the same time,the incidence of colorectal cancer among people under the age of 50 is also on the rise in China,and the incidence of colorectal cancer is becoming younger.In this case,people put forward higher requirements for the diagnosis and treatment of colorectal cancer.At present,the clinical diagnosis and treatment of rectal cancer has entered the stage of multidisciplinary comprehensive treatment,but the focus is still surgical treatment.In 1991,the first minimally invasive laparoscopic resection of sigmoid carcinoma was performed,marking the beginning of minimally invasive surgical treatment of colorectal cancer.However,conventional laparoscopic surgery still requires a 5～7cm auxiliary incision in the abdomen to remove the specimen,which increases the risk of postoperative incision-related complications.In order to further reduce surgical trauma,surgical complications and improve the quality of life of patients,Professor Wang xishan proposed the concept of Noses in 2013 and successfully performed the first Noses in the world.Currently,Noses are widely used in various organs and tissues in the abdomen and pelvis.A large number of clinical studies have shown that there is no significant difference in postoperative complications,such as intraoperative lymph node dissection,intraoperative blood loss,postoperative abdominal infection,postoperative tumor recurrence,when compared to conventional laparoscopic NOSES.Noses require total endoscopic reconstruction of the digestive tract,which makes reconstruction of the digestive tract a difficult part in Noses.In the process of digestive tract reconstruction,direct colon-anal anastomosis is often used,which may lead to the occurrence of low anterior rectal resection syndrome and anastomotic fistula.For this reason,we adopted a new anastomosis method called "bag like end-to-side anastomosis",and conducted in-depth studies on its safety and effectiveness.ObjectiveTo evaluate the clinical application value,feasibility,safety and short-term efficacy of bag-like end-to-side anastomosis in low rectal cancer Noses.MethodsThe first affiliated hospital of Zhengzhou university were retrospectively analyzed in colorectal surgery anus in September 2018 to December 2019 to take"class storage bag end side anastomosis method" complete laparoscopic rectal cancer in 52 patients with NOSES as research group(group A),at the same time line end to end anastomosis of 55 patients with laparoscopic surgical low rectal cancer NOSES as control group(group B),the two groups of patients with intraoperative and postoperative related indicators were compared.ResultsAll the patients underwent surgery successfully,and there was no transfer to open surgery or other surgical methods,and no intraoperative and postoperative death cases.There was no difference in preoperative and intraoperative parameters between the two groups(P>0.05).The incidence of anastomotic fistula in the A group was lower than that of the B group,and the difference was statistically significant(P<0.05).The anal function of group A was better than group B at 1 and 3 months after operation,and the difference was statistically significant(P<0.05).Conclusion1、The bag type end-to-side anastomosis is feasible and safe to use in laparoscopic low rectal cancer NOSES2、The bag type end-to-side anastomosis can effectively reduce anastomotic leakage after Noses in laparoscopic low rectal cancer3、The bag type end-to-side anastomosis reduces the incidence of low anterior rectal resection syndrome in patients with rectal cancer... |
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