摘要
目的分析经自然腔道取标本手术(NOSES)完全腹腔镜下结直肠癌根治术后患者腹腔冲洗液的肿瘤细胞学检测、细菌培养的结果及其临床意义。方法留取2016年1月至2018年4月湘雅医院普外结直肠肛门外科30例行NOSES完全腹腔镜下结直肠癌根治术患者术后腹腔冲洗液,分装两份,分别送病理科查找肿瘤细胞和检验科行细菌培养,收集肿瘤细胞学检测及细菌培养结果,并与国内外文献报道的开腹和常规腹腔镜结直肠癌根治术腹腔冲洗液的肿瘤细胞检测及细菌培养结果比较分析。结果 30例NOSES完全腹腔镜下结直肠癌根治术患者的腹腔冲洗液肿瘤细胞阳性的患者0例,阳性率0%(0/30);细菌培养阳性的患者有10例,阳性率33.3%(10/30);至目前为止30例NOSES患者术后均未出现盆/腹腔感染及盆/腹腔肿瘤的复发转移。这一结果与国内外文献报道的开腹及常规腹腔镜结直肠癌根治术后腹腔冲洗液的肿瘤细胞学检查(0%~45.5%)和细菌培养结果(20%~32.5%)相近。结论与开腹和常规腹腔镜结直肠癌根治术相比,NOSES结直肠癌根治术未增加患者术后盆腹腔感染及未促进肿瘤细胞种植转移,符合恶性肿瘤根治术的无菌无瘤原则,值得临床推广应用。
ObjectiveTo analyse the results of peritoneal lavage cytology and microbiology in patients with total laparoscopic resection for colorectal cancer by NOSES. MethodsExamination of cytology and microbiology of peritoneal lavage were performed for thirty colorectal cancer patients who underwent total laparoscopic resection by NOSES from January 2016 to April 2018, then compared with the other studies reported about peritoneal lavage for cytology and microbiology of open and laparoscopic radical resection for colorectal cancer at home and abroad. ResultsThirty colorectal cancer patients who underwent total laparoscopic resection by NOSES were performed the examination of peritoneal lavage for cytology and microbiology. There was no patients with positive cytology result （positive rate 0%）, ten patients were with positive microbiology result （positive rate 33.3%） , no patients were with abdominopelvic cavity infection and tumor recurrence in abdominopelvic cavity. Our results were similar to the other studies reported about peritoneal lavage for cytology （0%~45.5%） and microbiology （20%~32.5%） of open and laparoscopic radicalresection for colorectal cancer at home and abroad. ConclusionTotal laparoscopic resection for colorectal cancer by NOSES didn＇t increase the rate of intraperitoneal implantation of colorectal cancer cells and intra-abdominal infections. It is worthy of clinical application and promotion conforming to the principle of aseptic and non tumor.
作者
彭健
丁成明
贾泽民
陈杰
赵丹
张洋
杨智
邱俊
骆冬仁
何胖祥
钟树武
Peng Jian;Ding Chengming;Jia Zemin;Chen Jie;Zhao Dan;Zhang Yang;Yang Zhi;Qiu Jun;Luo Dongren;He Panxiang;Zhong Shuwu(Departmemt of General Surgery of Xiangya Hospital,Central South University,Changsha 410008,China;Departmemt of General Surgery of the First Affliate Hospital,University of South China,Hengyang 421001,China)
出处
《中华结直肠疾病电子杂志》
2018年第4期342-346,共5页
Chinese Journal of Colorectal Diseases(Electronic Edition)
基金
湘雅医院-北大未名临床与康复研究基金项目(No.20160201CF)
湖南省自然科学基金项目(No.2017JJ2334)
湖南省自然科学基金项目(No.2018JJ3471)
湖南省卫生计生委2018年度科研计划课题项目(No.C20180156)
关键词
结直肠肿瘤
经自然腔道取标本手术
细胞学检查
微生物学检查
无菌无瘤技术
Colorectal neoplasms
Natural orifice specimen extraction surgery （NOSES）
Cytology
Microbiology
Aseptic and tumor-free technique
