Clinical Analysis Of Laparoscopic-assisted Natural Orifice Specimen Extraction Subtotal Colectomy For Redundant Colon

Aim:To explore the effect of laparoscopic-assisted subtotal colectomy in the treatment of redundant colon.At the same time,To compare the differences of intraoperative situation,postoperative recovery and postoperative complications between laparoscopic-assisted subtotal colectomy with natural orifice specimen extraction surgery(LA-NOSE)and the traditional laparoscopy that took out specimens through small incisions Assisted subtotal colectomy by retrospective analysis,in order to summarize the best clinical decision-making basis for surgical treatment of redundant colon.Methods:We enrolled 34 patients with redundant colon who met the requirements of clinical research underwent laparoscopic assisted subtotal colectomy in Zhongshan Hospital of Xiamen University between January 2009 and June 2020.The detailed hospitalization data of 34 patients with redundant colon during their hospitalization were collected.To analyze the efficacy of 34 cases of laparoscopic assisted subtotal colectomy(including LA-NOSE subtotal colectomy and traditional laparoscopic assisted subtotal colectomy)in the treatment of redundant colon.Among the 34 patients,There were 16 cases patients who underwent LA-NOSE subtotal colectomy,and there were 18 cases patients who underwent the traditional laparoscopy that took out specimens through small incisions Assisted subtotal colectomy.SPSS statistics25.0 software was used to perform single-factor chi-square test on surgical treatment effects,intraoperative conditions,postoperative recovery conditions,and postoperative complications to screen out suitable treatment methods.Result:Patients in observation group 1(after surgical treatment)had bowel movements per week(p=0.000),labored defecation symptom(p=0.000),and lumpy or hard stools symptom(p=0.000)compared with control group 1(before surgery)showed significant statistical difference.Patients in observation group 2(LA-NOSE subtotal colectomy)were sitting and standing within 24 hours after surgery(p=0.004),leaving the bedside within 2 days after surgery(p=0.012),and moving within 3 days after surgery(p=0.022),recovery of gastrointestinal function within 2 days after operation(p=0.042),liquid diet within 3 days after operation(p=0.009),suture removal 6-7 days after operation(p=0.000),The surgical incision infection(p=0.045)was significantly different from the control group 2(traditional laparoscopic-assisted subtotal colectomy with small incisions to remove specimens).Observation group 2 had operation time(p=0.108),intraoperative blood loss(p=0.091),postoperative intestinal obstruction(p=0.932),postoperative anastomotic leakage(p=0.932),There is no significant statistical difference with the control group 2.Conclusion:Laparoscopic assisted subtotal colectomy can significantly improve the symptoms of reduced defecation,dry stool and labored defecation in patients with redundant colon.La-NOSE subtotal colectomy has the advantages of low incision infection rate,good cosmetic effect and fast postoperative recovery.(It can remove the surgical suture earlier;the patient can sit up earlier after the operation,move away from the bedside,and move;the patient’s gastrointestinal function recover faster,eat a liquid diet earlier.)...