Cutting-Edge Strategies in Minimal Invasive Left Hemicolectomy for Tumors around the Splenic Flexure: Analyzing the Short-term Outcomes Between Transrectal Natural Orifice Specimen Extraction and Conventional Laparoscopy

Abstract

Background The short-term outcomes of laparoscopic anterior resection with natural orifice specimen extraction (NOSE) are favorable. NOSE is, however, rarely used during left hemicolectomy surgeries. We retrospectively compared the feasibility, safety, and short-term results of transrectal NOSE for patients undergoing laparoscopic left hemicolectomy with conventional mini-laparotomy specimen extraction.Methods All patients who received laparoscopic left hemicolectomy surgery between January 2018 and December 2021, including 144 who underwent conventional surgery with specimen extraction through mini-laparotomy and 23 who underwent transrectal NOSE surgery, were enrolled in a single hospital. Surgical outcomes were assessed, including complications, postoperative short-term recovery, and pain level.Results The NOSE group had a shorter operation time, earlier postoperative recovery, a lower degree of pain on postoperative day 1, and a shorter hospital stay compared with the conventional group. In addition, postoperative morbidity was not noted in the transrectal NOSE group but was found in seven patients in the conventional group.Conclusion Laparoscopic left hemicolectomy with transrectal NOSE is a safe and feasible technique that results in quicker postoperative recovery and a shorter hospital stay. The advantages of transrectal NOSE compared to traditional mini-laparotomy in laparoscopic left hemicolectomy are being conducted for the first time in this study.