A Clinical Comparison Of Laparoscopic Resection For Sigmoid Colon And Upper Rectal Cancer By Transanal NOSES And Traditional Surgery

Objective: To investigate the safety and feasibility of transanal NOSES in laparoscopic sigmoid colon and upper rectal cancer.Methods:The clinical data of patient underwent laparoscopic sigmoid colon cancer and upper rectal cancer resection in the gastrointestinal surgery of our hospital from October 2018 to October 2020 were collected,including 30 cases who underwent transanal natural orifice specimen extractiom surgery(observation group)and 30 cases who underwent traditional surgery(control group).The operation time,intraoperative biood loss,intraoperative lymph node dissection,postoperative pain score,additional analgesics,recovery time of intestinal function,postoperative complications,postoperative hospital stay,local and distant recurrence were compared between the two groups.Results: The clinical baseline data of the two groups were comparable.There were no significant differences in intraoperative blood loss,number of intraoperative lymph nodes dissection and incidence of postoperative complications(P > 0.05).The operation time of the observation group was longer than that of the control group(221.27±31.35VS204.43±31.14 min,P <0.05).The postoperative pain score on the first day of the observation group was lower than that in the observation group(2.90±0.84VS3.77±1.70 points,P < 0.05).The use of additional analgesics in the observation group was less than that in the control group 4(13.3%)cases vs.18(60%)cases(P <0.05);The postoperative exhaust time of the observation group was shorter than that in the control group(2.80±0.55VS3.13±0.57 days P < 0.05).The duration of fluid diet in observation group was shorter than that in control group(4.83±0.87VS5.50±0.73 days P < 0.05).The postoperative hospital stay in the observation group was shorter than that in the control group(9.66±2.26VS1.00±2.39 days,P < 0.05).Patients in both groups were followed up for 4-28 months,with a median of 18 months,and no local and distant recurrence was observed.In conclusion,the observation group was superior to the control group in postoperative pain score on the first day,additional analgesics,postoperative exhaust time,duration of fluid diet and postoperative hospital stay.There were no significant differences in intraoperative blood loss,number of lymph nodes dissected and postoperative complications between the two groups.The observation group had longer operation time than the control group.Conclusion: The method of transanal natural orifice specimen extractiom surgery is safe and feasible for laparoscopic sigmoid colon and upper rectal cancer surgery.It has the advantages of faster postoperative recovery,less pain,less tissue damage and shorter postoperative hospitalstay.Moreover,its oncological outcome is equivalent to that of traditional laparoscopic surgery,and it is worthy of clinical application.