Clinical Exploration Of NOSES In Laparoscopic Rectal Cancer Surgery

Objective: By comparing the clinical case data and perioperative data of laparoscopic NOSES operation and laparoscopic-assisted radical resection of rectal cancer(Dixon)in the treatment of rectal cancer,the results of each treatment were analyzed.Explore the safety and effectiveness of laparoscopic NOSES surgery in the treatment of rectal cancer,and provide a theoretical basis for its extensive clinical application.Methods: A retrospective analysis of the clinical case data of 66 patients undergoing laparoscopic rectal cancer surgery at Yijishan Hospital of Wannan Medical College from March 1,2016 to November 1,2020,according to different surgical procedures,31 of them received natural Radical rectal cancer specimens were collected through the cavity(NOSES group);35 cases received laparoscopic-assisted radical resection of rectal cancer(Dixon group).All patients were diagnosed with rectal cancer by colonoscopy and pathological examination before operation.Statistical analysis was carried out by comparing and analyzing the general data of the two groups of patients before operation,operation-related indexes,post-operation related indexes,lymph node dissection,and anal function evaluation 3 months after operation.Results: The two groups of patients did not show statistical differences in general data:gender,body mass index(BMI),age,tumor location,tumor differentiation,and hypertensive diabetes mellitus(P>0.05),which were comparable;the NOSE group had postoperative The advantages of early ventilation time(P=0.021),early first meal time(P=0.042),short presacral drainage tube indwelling time(P=0.042),and low postoperative pain score(P=0.003);NOSES operation time is longer than Dixon Group(P=0.001);the two groups showed no statistical differences in intraoperative blood loss,catheterization time,average hospital stay,postoperative complications,and lymph node dissection(p>0.05);the two groups showed no statistical differences in terms of postoperative 3 There was no statistical difference in monthly anal function(p>0.05).Conclusion: Compared with the traditional laparoscopic-assisted radical resection of rectal cancer(Dixon),the application of specimen collection through natural cavity in the treatment of rectal cancer does not increase postoperative complications(abdominal infection,anastomotic leakage,postoperative bleeding,anal In the case of functional impairment,etc.),it also has the advantages of less abdominal wall trauma,early postoperative ventilation,and less pain,which makes the abdominal wall more beautiful and improves the subjective comfort of patients after surgery.NOSES is safe and feasible in laparoscopic rectal cancer surgery,and NOSES adheres to the concept of minimally invasive treatment,which has important value in clinical promotion.