CAJ | 학술논문

目的：探讨经自然腔道标本取出腹腔镜直肠癌根治术的治疗效果。方法直肠癌35例应用经自然腔道标本取出（NOSE）技术，完成腹腔镜直肠癌低位前切除术。分析其临床资料、术后排气时间、淋巴结清扫数目、吻合口瘘发生率等。结果35例均行腹腔镜直肠癌根治术，低位保肛成功，未行预防性横结肠造口术，其中，NOSE 腹腔镜直肠癌根治术成功率为85.71％（30/35），手术时间为105~186分钟（平均时间为129.50分钟）。肛门排气时间为22~80小时（平均为38.13小时）。术后住院时间为9~21天（平均10.27天）。1例发生吻合口瘘，2例发生穿刺口感染。结论经自然腔道标本取出的腹腔镜直肠癌根治术治疗中低位直肠癌效果安全、可靠。
목적：탐토경자연강도표본취출복강경직장암근치술적치료효과。방법직장암35례응용경자연강도표본취출（NOSE）기술，완성복강경직장암저위전절제술。분석기림상자료、술후배기시간、림파결청소수목、문합구루발생솔등。결과35례균행복강경직장암근치술，저위보항성공，미행예방성횡결장조구술，기중，NOSE 복강경직장암근치술성공솔위85.71％（30/35），수술시간위105~186분종（평균시간위129.50분종）。항문배기시간위22~80소시（평균위38.13소시）。술후주원시간위9~21천（평균10.27천）。1례발생문합구루，2례발생천자구감염。결론경자연강도표본취출적복강경직장암근치술치료중저위직장암효과안전、가고。
Objective To investigate the therapeutic effect of laparoscopic radical resection of rectal carcinoma via natural orificespecimen extraction(NOSE). Methods Laparoscopic resection of rec-tal carcinoma was performed using NOSE technique in 35 cases of rectal cancer from October 2013 to 2015 July. Analysis of clinical data,postoperative exhaust time,the number of resected lymph node,and anastomotic leakage rate was conducted. Results All 35 cases underwent laparoscopic radical resection of rectal cancer with successful anus preservation. There were no preventive transverse colostomy. Among them,the success rate of laparoscopic radical resection via NOSE for rectal cancer was 85. 71%(30 /35). The operation duration ranged from 105 to 186 min(mean 129. 50 min). Anal exhaust time was 22 to 80 h(average 38. 13 h). Postoperative hospital stay lasted for 9 ~ 21 days(mean 10. 27 d). Anas-tomotic leakage occurred in 1 case and puncture infection in 2 cases. Conclusion Laparoscopic radical resec-tion of rectal carcinoma in middle and low rectal cancer is safe and reliable,which is worthy of being spread.