Application Of NOSE Surgery Combined With Rapid Rehabilitation In The Treatment Of Colorectal Cancer

Research background and purpose:At present,the treatment of colorectal cancer includes surgery,radiotherapy,chemotherapy,and surgical resection of tumor is the first choice for the treatment of colorectal cancer.With the development of surgical techniques and surgical instruments,laparoscopic minimally invasive surgery has become the mainstream of surgical treatment,which has been widely developed.NOTES surgery is more minimally invasive than laparoscopic surgery,almost reached the surface of the "no scar" of the highest level[1]-[2],but there are still many key problems can not be solved well.Laparoscopic surgery and NOTES surgery have their own advantages and disadvantages.In this regard,the emergence of NOSE operation is a product of the concept of minimally invasive laparoscopic surgery and NOTES surgery operation advantage combination,can be said to be a "perfect combination",to take samples of the abdominal wall through natural cavity without auxiliary incision surgery than traditional laparoscopic trauma,faster postoperative recovery.On the other hand,the ERAS by optimizing perioperative measures,including preoperative,intraoperative and postoperative treatment,to reduce interference in the body of patients with balance,to reduce stress reaction and improve the efficacy of patients with surgery and reduce postoperative complications,to speed up postoperative rehabilitation,shorten the hospital stay.Laparoscopic surgery,Nose surgery and ERAS concept are to reduce the patient's postoperative stress,improve the clinical treatment of patients,to speed up the rehabilitation of patients for the purpose.So how is the effect of NOSE surgery combined with accelerated rehabilitation surgery in colorectal cancer patients?This study explored the application of the NOSE surgery combined with rapid rehabilitation surgery(ERAS)in the treatment of sigmoid colon and rectal cancer.Objects and methods:In this study,we selected 90 patients with sigmoid colon cancer and rectal cancer from October 2013 to February 2016 in Department of general surgery of Zhujiang Hospital affiliated to Southern Medical University.They were randomly divided into three groups:traditional nursing control group(laparoscopic surgery plus traditional nursing care),laparoscopic control group(traditional laparoscopic surgery plus ERAS regimen)and NOSE group(NOSE plus ERAS.Randomized controlled trials comparing three groups of patients with intraoperative and postoperative conditions and pain scores.Result:3 groups of patients were successfully completed the operation,no patient died,the time of anesthesia,operation time and intraoperative blood loss was not statistically significant(P>0.05).Laparoscopic surgery in the control group after the first exhaust time,first defecation time,postoperative hospitalization time and average,hospitalization expenses and postoperative complication rate is lower than the traditional nursing group.NOSE group of postoperative first exhaust time,first defecation time,postoperative hospitalization time and average hospitalization expenses and postoperative third days of CRP,IL-6,and cortisol index was lower than the other two groups,the differences were statistically significant(P<0.05).The postoperative pain scores of the laparoscopic control group were better than those of the traditional nursing control group,and the postoperative pain score of the NOSE group was superior to the other two groups,the difference was statistically significant(P<0.05).Conclusion:NOSE surgery combined with ERAS regimen for treatment of patients with sigmoid colon and rectal cancer is more advantageous than traditional laparoscopic treatment and its combined ERAS regimen.