腹腔镜直肠固定术与自然腔道标本提取（NOSE）和体内吻合术（ICA）的技术可行性和围...

腹腔镜直肠乙状结肠切除术 (LRR) 是治疗梗阻性排便综合征最有效的方法，但与经肛门入路相比，术后并发症发生率更高。 自然孔道标本提取 (NOSE) 被描述为一种有前途的技术，可降低结直肠癌手术的发病率。 在这项研究中，分析了将该技术应用于 LRR 的技术挑战，并将围手术期结果与传统的腹腔镜技术进行了比较，该技术通过小切口和体外吻合术提取标本。

回顾性分析了 45 例在机构接受腹腔镜直肠乙状结肠切除术的直肠固定术患者。 从 2020 年 9 月到 2021 年 7 月，连续治疗了 17 名 NOSE-LRR 患者，并将结果与 2019 年 1 月至 7 月期间接受常规腹腔镜直肠乙状结肠切除术、直肠固定术和小切口开腹术 (LAP-LRR) 进行标本提取的 28 名连续患者的历史队列进行了比较 2020 年。在 6 个月的随访后，评估了患者和疾病的特定参数、手术时间、住院和术后并发症以及患者的主观满意度。

两组在性别分布、年龄和合并症方面具有可比性。 两组的中位手术时间相似，围手术期并发症发生率也相当。 NOSE-LRR 组的住院时间明显更短（中位数 6 天 vs 8 天）。

NOSE-LRR 可以安全实施，手术时间相当，术后并发症发生率也相当。 与传统的腹腔镜技术相比，该技术提供了潜在的快速术后恢复。

腹腔镜直肠固定术与自然腔道标本提取（NOSE）和体内吻合术（ICA）的技术可行性和围...

经肛门标本提取和下直肠造口术的体内准备。 A 用单极剪刀切开直肠，并用一根额外的固定线露出内腔。 B 标本经肛门提取。 C 经肛门插入砧座后，用带角度的线性吻合器解剖降结肠。 D 在缝合线处拔出砧座，并使用经肛门引入的圆形吻合器进行吻合。

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