Laparoscopic radical right hemicolectomy with transrectal-specimen extraction: a novel natural-orifice specimen-extraction procedure

Sun, Peng; Liu, Zheng; Guan, Xu; Luo, Shou; Cai, Xu-Hao; Li, Jingwen; Wang, Xishan

doi:10.1093/gastro/goaa047

Cited by 6 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, in men or young unmarried women with right-sided colon cancer, specimens can only be retrieved through the rectal route during NOSES procedure. However, the number of reports of transrectal specimen extraction after laparoscopic right hemicolectomy is less, and all of them are case reports ( 10 , 11 ). In present study, we analyzed 24 patients who underwent transrectal specimen extraction after laparoscopic right hemicolectomy, and the results showed that the incidence of incision infection was significantly lower in the NOSES group than in the LAP group.…”

Section: Discussionmentioning

confidence: 99%

“…However, for men or young unmarried women with high locations of colon tumor, only transrectal NOSES can often be performed. Currently, laparoscopic radical right hemicolectomy with transrectal-specimen extraction is rarely carried out in clinical practice, with few literature reports ( 10 , 11 ). This study retrospectively analyzed the short-term and long-term effects of transrectal specimen extraction after laparoscopic right hemicolectomy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Short-term and long-term survival outcomes for transrectal specimen extraction after laparoscopic right hemicolectomy: a propensity-score matching study

ReDati,

Li,

Jiang

et al. 2024

Front. Oncol.

View full text Add to dashboard Cite

BackgroundNatural orifice specimen extraction surgery (NOSES) has been widely applied to the treatment of colorectal cancer. This study aim to investigate the short-term and survival outcomes of transrectal specimen extraction after laparoscopic right hemicolectomy.MethodsFrom January 2016 to December 2021, a total of 166 consecutive patients with right colon cancer who underwent laparoscopic right hemicolectomy in Cancer Hospital of Chinese Academy of Medical Sciences and Beijing Hospital were identified. Baseline data, perioperative parameters, anal function, inflammatory indicators and survival outcomes were collected and compared.ResultsTotally, 24 patients who underwent transrectal NOSE were matched with 24 patients who received conventional laparoscopic surgery (LAP). Patients in NOSES group had a significantly lower incidence of incision infection (0 vs 20.8%, P=0.048), faster recovery of gastrointestinal function (2.1 vs 3,1 days, P=0.032) compared with those in LAP group. In addition, patients in the NOSE group experienced significantly less postoperative pain on POD1 (2.3 vs 4.4, P<0.001), POD3 (2.1 vs 3.9, P<0.001), and POD5 (1.7 vs 2.8, P=0.011). Regarding to anal function 6 months after surgery, no significant difference was observed in Wexner incontinence scale (9.8 vs 9.5, P=0.559) between the two groups. In terms of indicators of the inflammatory response, there were no significant differences in body temperature, neutrophils, and PCT levels between the two groups. However, CRP levels in the NOSES group on POD 3 (6.9 vs 5.1 mg/L, P=0.016) and POD 5 (3.8 vs 2.6 mg/L, P=0.027) were significantly higher than in the LAP group. With regarded to survival outcomes, patients in the NOSES group were similar to those in the LAP group for 3-year OS (100% vs 91.2%, P=0.949), 3-year DFS (86.2% vs 84.8%, P=0.949), and 3-year LRFS (94.2% vs 88.7%, P=0.549).ConclusionFor total laparoscopic right hemicolectomy, transrectal NOSE is effective and safe, and associated with lower incidence of wound infection, less pain, faster recovery, and similar survival outcomes compared to conventional laparoscopic surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Short-term and long-term survival outcomes for transrectal specimen extraction after laparoscopic right hemicolectomy: a propensity-score matching study

ReDati,

Li,

Jiang

et al. 2024

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…We recently reported our technique for 3-port laparoscopic D3 right hemicolectomy with transvaginal NOSE[ 13 ]. Transanal NOSE has been successfully performed and described following right-sided colonic surgery, in both male and female patients[ 14 , 15 ]. However, this approach requires an additional rectal incision and was avoided in our cohort, due to the added risk of luminal content spillage.…”

Section: Methodsmentioning

confidence: 99%

Outcomes after natural orifice extractionvsconventional specimen extraction surgery for colorectal cancer: A propensity score-matched analysis

Seow‐En¹,

Chen²,

Li³

et al. 2022

World J Clin Oncol

View full text Add to dashboard Cite

BACKGROUND Natural orifice specimen extraction (NOSE) via the anus or vagina replaces conventional transabdominal specimen retrieval via the transabdominal route through a limited mid-line laparotomy or Pfannenstiel incision. Reducing the number of laparoscopic ports further decreases operative abdominal wall trauma. These techniques reduce the surgical wound size as well as the risk of incision-related morbidity. AIM To compare short-term outcomes following 3-port NOSE surgery with a matched cohort of conventional non-NOSE colorectal cancer surgery. METHODS Patients who underwent elective 3-port laparoscopic colorectal NOSE surgery between February to October 2021 were identified. Selection criteria for NOSE surgery was adapted from the 2019 International Consensus on Natural Orifice Specimen Extraction Surgery for colorectal cancer. Patients with clinical T4 or N2 tumors on staging computed tomography were also excluded. The propensity score-matched cohort was identified amongst patients who underwent conventional laparoscopic colorectal surgery from January 2019 to December 2020. Matching was performed in the ratio of 1:4 based on age, gender, type of resection, and p - tumor node metastasis staging. RESULTS Over the eight-month study duration, 14 consecutive cases (nine female, five male) of elective 3-port laparoscopic surgery with NOSE were performed for colorectal cancer. Median age and body mass index were 70 (range 43-82) years and 24.1 (range 20.0-31.7) kg/m 2 respectively. Six patients underwent transanal NOSE and eight had transvaginal NOSE. Median operative time, intraoperative blood loss and postoperative length of stay were 208 (range 165-365) min, 30 (range 10-150) mL and 3 (range 2-6) d respectively. Two (14%) suffered minor postoperative compilations not attributable to the NOSE procedure. Median follow-up duration was 12 (range 8-15) mo. No instances of mortality, local or distant disease recurrence were recorded in this cohort. Compared to the conventional surgery cohort of 56 patients, the 3-port NOSE cohort had significantly quicker mean return of bowel function (2.6 vs 1.2 d, P < 0.001), reduced postoperative pain and patient-controlled analgesia use, and decreased length of hospital stay (6.4 vs 3.4 d, P < 0.001). There were no statistical differences in surgical duration and perioperative complication rates between the NOSE and non-NOSE cohorts. CONCLUSION 3-port laparoscopic colorectal surgery with NOSE is a feasible technique, augmenting the minimally invasive nature of surgery and producing good outcomes. Appropriate patient selection and expertise in conventional laparoscopy are required.

show abstract

“…However, laparoscopic surgery still requires a mini-laparotomy for anastomosis and extraction of specimens, increasing the risk of incisional hernia, wound infection, and even tumor implantation in patients [5][6][7]. Therefore, natural ori ce specimen extraction surgery (NOSES) is proposed for specimen extraction through the anus or vaginal [8,9].…”

Section: Introductionmentioning

confidence: 99%

Reduced-port laparoscopic colectomy with D3-lymph node dissection and transvaginal specimen extraction (NOSES VIIIa) for right colon cancer: clinical features

Efetov,

Cao,

Panova

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Reduced-port laparoscopic surgery (RPLS) is the minimum possible number of ports or small-sized ports in laparoscopic surgery. Although the damage has been reduced compared to conventional laparoscopic (CL) surgery, a mini-laparotomy (ML) is still required to extract the specimen. The combination of RPLS and natural orifice specimen extraction (NOSE) minimizes the damage of the procedure. Methods: First group, we present the surgical approach of RPLS and extract the specimen via vaginal. Second group, we present the CL and extract the specimen through mini-laparotomy. We highlight the first surgical approach that includes preoperative preparation, key steps during the operation, and postoperative outcomes Results: A total of 17 patients with right colon adenocarcinoma, 5 of them underwent RPLS-NOSE, and other 12 patients underwent conventional laparoscopic (CL) surgery and extract specimen by mini-laparotomy (CL-ML). Compare with CL-ML, RPLS-NOSE associated with longer operative time (289 min vs 231 min, P < 0.001), less bleeding (60 ml vs 90 ml, P = 0.025), short hospitalization (8.2 days vs 13.6 days, P<0.001), faster first flatus (1.8 days vs 3.4 days, P<0.001), less postoperative pain on first day (2.8 vs 4.25, P = 0.019). Regarding to lymph node harvest, bowal movement, R0 resection, postoperative comlications, postoperative pain on day 3 and day 5, no significant difference was observed. Conclusion: In selected patients, RPLS with D3-lymph node dissection and transvaginal specimen extraction is safe, results in fast recovery, and is indicated for colon cancer patients.

show abstract

Laparoscopic radical right hemicolectomy with transrectal-specimen extraction: a novel natural-orifice specimen-extraction procedure

Cited by 6 publications

References 11 publications

Short-term and long-term survival outcomes for transrectal specimen extraction after laparoscopic right hemicolectomy: a propensity-score matching study

Short-term and long-term survival outcomes for transrectal specimen extraction after laparoscopic right hemicolectomy: a propensity-score matching study

Outcomes after natural orifice extractionvsconventional specimen extraction surgery for colorectal cancer: A propensity score-matched analysis

Reduced-port laparoscopic colectomy with D3-lymph node dissection and transvaginal specimen extraction (NOSES VIIIa) for right colon cancer: clinical features

Contact Info

Product

Resources

About