NOSES对腹腔镜直肠癌根治术后腹腔冲洗液肿瘤细胞学及细菌培养结果的影响

doi:10.3969/j.issn.1671-7171.2023.03.002

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Abstract 【Objective】 To investigate the effect of natural orifice specimen extraction surgery (NOSES) on the oncology and bacterial culture of peritoneal lavage fluid after laparoscopic radical resection of rectal cancer. 【Methods】 Thirty-eight patients with rectal cancer admitted to our hospital from May 2020 to January 2022 were prospectively selected for laparoscopic radical resection of rectal cancer. According to the random number table method and combined with the wishes of patients,they were divided into NOSES group (16 cases) and non NOSES group (22 cases). The results of tumor cells exfoliated from peritoneal lavage fluid and bacterial culture indicators were compared between the two groups.【Results】 Mesothelial cells and lymphocytes were visible in the peritoneal lavage fluid of the two groups of patients during surgery,and no exfoliated tumor cells were found. The positive rate was 0 for both groups,with no statistically significant difference between the two groups (P>0.05). In the NOSES group,4 cases of the 16 cases in the intraoperative peritoneal lavage fluid bacterial culture medium were positive,with a positive rate of 25.0%,including 3 cases of Escherichia coli and 1 case of Enterococcus faecium. Among the positive cases,1 patient had recurrent high fever after surgery. CT showed that the pelvic abscess recovered after anti infection and drainage. In the non NOSES group,5 cases were positive in the bacterial culture medium of intraoperative peritoneal lavage fluid,with a positive rate of 22.7%,including 4 cases of Escherichia coli and 1 case of Klebsiella pneumoniae. There were no cases of abdominal infection. There was no statistically significant difference in the positive rates between the two groups(χ²=0.026,P>0.05). 【Conclusion】 Compared with traditional laparoscopic radical resection of rectal cancer,transanal NOSES laparoscopic radical resection of rectal cancer does not significantly increase the risk of surgical tumor dissemination and abdominal infection,and conforms to the principle of aseptic and tumor free.

Key words： Rectal Neoplasms/SU Laparoscopy Specimen Handling Peritoneal Lavage Bacteriological Techniques

Received: 02 August 2022

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R735.37

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2023.03.002 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2023/V40/I3/325

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