| Objective: By comparing the clinical efficacy of transanal NOSES and traditional laparoscopic surgery in the treatment of rectal cancer,to discuss whether the application of transanal NOSES in the treatment of rectal cancer is safe and effective,so as to provides reference for the application and promotion of NOSES surgery.Methods: A retrospective study was conducted to collect the clinical data of 57 patients with rectal cancer from July 2018 to September 2019.According to the different methods of operation,the observation group(n=20)underwent natural orifice extraction surgery,and the control group(n=37)underwent laparoscopic surgery.According to the time of operation,the amount of blood loss during operation,the first time of getting out of bed after operation,the time of first exhaust after operation,the time of eating for the first time after operation,the time of removal of abdominal drainage tube after operation,the time of hospitalization after operation,the cost of hospitalization,whether to add analgesics after operation,the incidence of complications such as postoperative anastomotic leakage,postoperative abdominal infection,postoperative abdominal bleeding,postoperative intestinal obstruction,postoperative pulmonary infection,postoperative incision liquefaction infection,etc.The postoperative pathological data and follow-up within half a year after operation were observed and analyzed by SPSS22.0 statistical software,and the data of NOSES group and traditional laparoscopy group were compared.Results: After comparison,the first time of getting out of bed after operation(P<0.001),the time of first exhaust after operation(P<0.001),the time of first eating after operation(P=0.045),the time of hospitalization after operation(P=0.013),hospitalization costs(P<0.001),the infection rate of lung after operation(P=0.041),and the infection rate of incision liquefaction after operation(P=0.020)in the NOSES group were superior to those in the traditional laparoscopy group.However,the operation time of NOSES group was significantly longer than that of traditional laparoscopy group(P<0.001);the maximum diameter of tumor was significantly smaller than that of traditional laparoscopy group(P<0.001);and the tumor stage was significantly earlier than that of traditional laparoscopy group(P=0.001).There was no significant difference in intraoperative blood loss,postoperative drainage time,postoperative analgesics,postoperative complications(anastomotic leakage,abdominal infection,abdominal bleeding,intestinal obstruction),number of intraoperative lymph node dissection,tumor stage,anal function evaluation at 6 months after operation,local recurrence and distant metastasis 6 months after operation(P>0.05).Conclusions: Compared with traditional laparoscopic surgery for rectal cancer,transanal NOSES has the advantages of less abdominal wall trauma,early exhaustion after operation and quick recovery in the short-term treatment of rectal cancer.It does not increase the incidence of postoperative complications such as abdominal infection,anastomotic leakage,abdominal bleeding and intestinal obstruction,nor does it increase the incidence of postoperative anal function injury.Therefore,transanal NOSES for radical resection of rectal cancer is safe and effective,and it is worth popularizing.However,transanal NOSES has some limitations,it is mainly suitable for patients with small specimens and early tumor stages,and should be carried out by doctors with certain experience in laparoscopic surgery. |
