Effect of laparoscopic surgery for colorectal cancer with N. O. S. E. on recovery and prognosis of patients.

OBJECTIVE: To investigate the effect of laparoscopic surgery in colorectal cancer (CRC) patients with natural orifice specimen extraction (NOSE) on the recovery and quality of life (QOL) of patients. MATERIAL AND METHODS: Ninety-two eligible patients were randomly assigned into two groups: the traditional laparoscopy group (L group, n = 46) and the laparoscopic transanal specimen extraction group (NL group, n = 46). General data, surgery-related indicators, postoperative recovery, and prognosis were compared and analyzed between the two groups. RESULTS: A total of 46 patients in each group were enrolled in this study. The general data and surgery-related indicators were comparable between the two groups (all p > .05). There were no significant differences in the time of first flatus, bleeding, obstruction, constipation, and infectious complications between the two groups (all p > .05). The differences in the incidence of postoperative diarrhea, pain degree, and satisfaction on the aesthetics of the abdominal wall showed significant differences (χ2 = 6.133, p = .013; χ2 = 12.116, p = .017; χ2 = 13.463, p = .004). The postoperative follow-up time was 3-53 months. There were no significant differences in the postoperative hospital stay, medical costs, hospital readmission rate, incidence of incisional hernia, overall survival, disease-free survival, and QOL between the two groups (all p > .05). Conclusion: Laparoscopic surgery with NOSE for eligible patients with CRC was a feasible choice.

Patient-specific finite element analysis of frictional behavior in different esophageal regions during endoscopy.

PURPOSE: Endoscopy is a common and effective method to treat digestive system diseases. Not only can it detect the physiological state of the digestive tract, but also can conduct clinical operations. As a result, it's of great significance to make clear the relationship between the clinical operation and the complications. METHODS: Considering the difficulty in measuring the contact force and determining the stress distribution in real time during endoscopy, a specific-patient finite element model for the frictional behavior at the endoscope-esophagus interface was built in current study. By collecting the CT data of the patient, a 3D esophagus model was built and divided into three characteristic regions (narrow region, thoracic region and abdominal region) according to the physiological structure. RESULTS: Results showed that the radius of the narrowest position was the dominant factor for the maximum von Mises stress when the endoscope passed through the narrow region. For abdominal region and thoracic region, with the increasing coefficient of friction (COF) and amplitude, the total force duo to frictional force (CFSM), frictional dissipation (FD), strain energy (SE) and maximum von Mises stress (Max) all increased correspondingly. Meanwhile, the region of stress concentration gradually approached the initial contact stage. CONCLUSIONS: The results can provide theoretical basis and technical support for clinical application and offer some suggestions for medical workers during endoscopy as well.