| Objective:As a common malignant tumor of the digestive tract,rectal cancer is mainly associated with genetic,environmental and other factors.In recent years,the incidence of rectal cancer has been increasing,which can cause a series of complications such as intestinal obstruction,and the long-term survival rate and quality of life of patients have been greatly affected.Chemotherapy and drug therapy can only be used as the corresponding adjuvant treatment,and radical resection is the most effective treatment for rectal cancer patients.Compared with traditional open surgery,such as large trauma,large intraoperative blood loss,and long postoperative recovery period,laparoscopic surgery is characterized by small wound area,slight pain and quick recovery.With the further development of minimally invasive surgery,in recent years,the laparoscopic resection for rectal cancer by Natural Orifice Specimen Extraction Surgery is more and more applied in the treatment of patients with rectal cancer.The purpose of this study is to investigate and compare the effect of the laparoscopic resection for rectal cancer by Natural Orifice Specimen Extraction Surgery with traditional laparoscopic surgery.Methods: The clinical data of 56 patients with carcinoma of the rectum admitted to The Lu,an Affiliated Hospital of Anhui Medical University from February 2013 to November 2018 were retrospectively analyzed.The subjects were divided into two groups according to different surgical methods:Among them,30 patients in the observation group received laparoscopic NOSES surgery,while 26 patients in the control group received traditional laparoscopic surgery.The positive and negative affect schedule(PANAS)score,sleep quality index,pain index and hospitalization time,operation time,recovery time of intestinal function,intraoperative blood loss,intraoperative lymph node dissection,postoperative complications were compared between the two groups.Serum Il-6 and Il-8 concentrations in the two groups were detected one day before surgery,one day after surgery,three days after surgery,and five days after surgery respectively,for comparison.Results:1,There were no significant differences between the two groups in gender,age,body mass index,distance between the lower margin of the tumor and the anal margin,and depth of tumor invasion in tumor diameter(P>0.05).2,The negative emotion score of the observation group was 42.37±10.69 points on the first day after the operation,while that of the control group was 58.27±11.86 points on the first day after the operation,P=0.000<0.05,the difference was statistically significant.The score of sleep quality on the first day after surgery was 7.50 ± 1.28 points in the observation group,and 10.65 ± 1.23 points in the control group,P=0.000<0.05,the difference was statistically significant.The pain index on the first day after surgery was 3.40±1.16 points in the observation group,and 5.23±1.18 points in the control group,P=0.000<0.05,the difference was statistically significant.The hospital stay in the observation group was 7.60±3.3 days,and that in the control group is 13.38 ± 5.9 days,P =0.000<0.05,the difference was statistically significant.The observation group was significantly better than the control group in terms of the positive and negative affect schedule(PANAS)score,sleep quality index,pain index and hospitalization time(P<0.05).3,The operation time of the observation group was 177.52±52.28 minutes,and that of the control group was 207.27 ± 66.55 minutes,P=0.084>0.05,the difference was not statistically significan.The duration of postoperative fluid diet in the observation group was 46.20 ± 5.77 hours,while that in the control group was 49.62 ± 7.19 hours.P=0.054>0.05,the difference was not statistically significan.The number of lymph nodes dissected during the operation was 17.47±7.45 in the observation group and 14.35±3.61 in the control group.The comparison between the two groups was P=0.557>0.05,and the difference was not statistically significant.The intraoperative blood loss was54.20±30.10 ml in the observation group and 53.23±27.79 ml in the control group.P=0.901>0.05,and the difference was not statistically significant.The overall incidence of postoperative complications in the observation group was 3.33%,with only one case of postoperative anastomotic leakage.The total incidence of postoperative complications in the control group was 3.85%,including one case of postoperative intestinal obstruction.The comparison between the two groups was p=0.918>0.05,and the difference was not statistically significant.There was no statisticaliy significant difference in the efficacy between the two groups in terms of operation time,recovery time of intestinal function,intraoperative blood loss,intraoperative lymph node dissection,postoperative complications(P>0.05).4,The serum Il-6 and Il-8 levels were compared between the two groups one day before and one day,three days and five days after surgery.The serum il-6 and il-8 values of the two groups showed an increasing trend one day before the operation,one day after the operation,three days after the operation and five days after the operation,and the comparison between the two groups showed no statistical significance.Conclusion:Compared with traditional laparoscopic rectal resection,laparoscopic resection for rectal cancer by NOSES has the advantages of less pain,faseter recovery,better aesthetic effect,and greatly reduces the incidence of incision infection complications.The postoperative mood and sleep state of the patients are better,and the compliance is higher.In addition,the operation of NOSES has the same effect as traditional laparoscopic surgery in the number of intraoperative lymph node dissection,intraoperative blood loss and other surgical treatment effects,which will not increase the incidence of abdominal infection and other complications,it is worthy of further clinical study and application. |
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