Comparison Of The Short-Term Efficacy Between Natural Orifice Specimen Extraction Surgery And Conventional Laparoscopic Surgery With Abdominal Auxiliary Incision Based On Propensity Score Matching Method

Object:To compare the short-term efficacy between natural orifice specimen extraction surgery(NOSES)and conventional laparoscopic surgery with abdominal auxiliary incision.Methods:This is a retrospective analysis of 264 cases of laparoscopic upper rectal cancer and sigmoid colon cancer surgery in the Department of Colorectal Tumor Surgery,Shengjing Hospital of China Medical University from January 2017 to January 2019.It is divided into 52 cases of natural orifice specimen extraction surgery(NOSES group)and212 cases of conventional laparoscopic surgery(control group),according to the way of surgery.The initial data were matched 1:1 by propensity score matching method,and 47cases in each of the two groups were finally obtained.SPSS26.0 was used for data analysis to compare the perioperative indicators,tumor pathological indicators,defecation function and survival of the two groups.Result:There was no statistically significant difference between the general data of the two groups(P>0.05).The time of first exhaust and eating liquid food after surgery in the NOSES group was earlier than that in the control group(P<0.05),and postoperative pain score and cosmetic result of NOSES group were both better than that of the control group(P<0.05).There was no statistically significant difference between the operative time,intraoperative blood loss,postoperative hospitalization time and the incidence of postoperative complications of the two group(P>0.05).The distance of distal incisal margin in NOSES group was longer than that in control group(P<0.01).There was no statistically significant difference in specimen length,distance of proximal resection margin,tumor diameter,number of lymph nodes,degree of tumor differentiation and TNM stage between the two groups(P>0.05).There was no significant difference in anal defecation function 6 months after operation(P>0.05).The short-term follow-up results showed that there was no statistically significant difference in postoperative recurrence rate between the two groups,and there was no statistically significant difference in diseasefree survival rate(DFS)between the two groups by Log-rank test(P>0.05).Conclusion : The short-term effect of NOSES is similar to that of conventional laparoscopic surgery,and NOSES has the advantages of more beautiful incision,less postoperative pain and faster recovery,which is more in line with the concept of minimally invasive and worthy of clinical promotion.