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  • 杜 涛,傅传刚.经自然腔道标本取出的腹腔镜结直肠切除术[J].同济大学学报(医学版),2019,40(6):767-773.    [点击复制]
  • DU Tao,FU Chuan-gang.Natural orifice specimen extraction surgery for laparoscopic colorectal resection[J].同济大学学报(医学版),2019,40(6):767-773.   [点击复制]
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经自然腔道标本取出的腹腔镜结直肠切除术
杜涛,傅传刚
0
(同济大学附属东方医院胃肠肛肠外科,上海 200120; 同济大学附属东方医院普外科,上海 2000120)
摘要:
目的 经自然腔道标本取出术(natural orifice specimen extraction surgery, NOSES)手术即通过自然腔道(结肠、直肠、肛管和阴道等)取出标本,从而避免腹部额外的切口。根据标本取出途径的不同,结直肠癌NOSES手术可以分为经结肠、经直肠、经肛门和经阴道4种方式。此外,根据取出的方式、直肠残端处理方法等可进一步分型。直肠癌NOSES手术的优点在于恢复更快,且没有发生切口感染和切口疝的风险,其争议主要包括腹腔污染、肿瘤播散。如何正确认识NOSES手术这一新的理念,具有重要的临床意义。本文主要对NOSES的发展史、优缺点以及不同手术方式的技术要点进行综述。
关键词:  经自然腔道标本取出  腹腔镜  结直肠切除术
DOI:10.16118/j.1008-0392.2019.06.001
投稿时间:2019-10-04
基金项目:上海市浦东新区临床高峰学科建设项目(PWYgf2018-04);上海浦东新区卫生系统重点专科建设项目(PWZZK2017-26)
Natural orifice specimen extraction surgery for laparoscopic colorectal resection
DU Tao,FU Chuan-gang
(Dept. of Colorectal Surgery, East Hospital, Tongji University School of Medicine, Shanghai 200120, China;Dept. of General Surgery, East Hospital, Tongji University School of Medicine, Shanghai 200120, China; 2. Dept. of General Surgery, East Hospital, Tongji University School of Medicine, Shanghai 200120, China)
Abstract:
Natural orifice specimen extraction surgery(NOSES) is to remove the specimen through the natural lumen such as colon, rectum, anal canal and vagina, so as to avoid additional abdominal incision. According to the ways of specimens deliveredextracted, the methods of NOSES for colorectal cancer can be divided into four ways: trans-colonic, trans-rectal, trans-anal and vaginal. In addition, it can be further classified according to the surgical methods and the treatment of rectal stump. The advantages of NOSES for colorectal cancer are faster recovery, and there is no risk of incision infection and hernia. Concerns associated with NOSES-technique include potential intraperitoneal contamination and tumor spread. How to correctly further understand the new concept of NOSES and its clinical application and significance is of great clinical significance. In this article the development history, advantages and disadvantages of NOSES, as well as the technical points of different surgical methods were are reviewed.
Key words:  natural orifice specimen extraction surgery  laparoscope  colorectal resection

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