Laparoscopy-Assisted Natural Orifice Specimen Extraction to Treat Tumors of the Sigmoid Colon and Rectum: The Short- and Long-Term Outcomes of a Retrospective Study

Chen, Chunqiu; Chen, Hong; Yang, Minwei; Wu, Xiaodi; Yuan, Xiaoqi; Zhu, Chunyan; Han, Yi; Li, Yin

doi:10.1089/lap.2018.0601

Cited by 17 publications

(11 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In their case series, no intraoperative or postoperative complications occurred, and patient satisfaction was very high according to the CPGAS score results. Chen et al 14 suggested that NOSE surgery of the sigmoid colon and rectal tumors suffered less postoperative complications. Analogously, in terms of short-term outcomes, this study revealed the postoperative VAS scale on day 1 and postoperative use of analgesics were significantly less, and patients passed flatus quickly in the NOSE group.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes and prognostic factors of robotic assisted rectal cancer resection alone versus robotic rectal cancer resection with natural orifice extraction: a matched analysis

Liu

Luo

Wan

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Robotic rectal cancer resection with natural orifice extraction is a recently developed minimally invasive surgery used in the treatment of patients with rectal cancer. However, its safety and feasibility remain undiscussed and controversial. this study reported the clinical outcomes and prognostic factors pertaining to traditional robotic assisted rectal cancer resection alone against that of robotic rectal cancer resection with natural orifice extraction to provide a discussion on this issue. 49 patients who underwent robotic rectal cancer resection with natural orifice extraction and 49 matched patients who underwent conventional robotic assisted rectal cancer resection were systematically analyzed in this study. Regarding the baseline characteristics, after matching, no significant differences were observed between the natural orifice specimen extraction (NOSE) group and the robotic assisted rectal cancer resection (RARC) group. Patients in the NOSE group had a reduced visual analog scale (p < 0.001), passed flatus more quickly (p = 0.002) and suffered less surgical stress than those in the RARC group. Moreover, 4 complications were observed in the NOSE group and 7 complications in the RARC group with no significant difference (p = 0.337) in terms of complications. The two groups had a similar survival outcomes, where the 3-year overall survival (p = 0.738) and 3-year progression-free survival (p = 0.986) were all comparable between the two groups. Histological differentiation and T stage could be regarded as independent prognostic factors for 3-year overall survival and 3-year progression-free survival. Robotic rectal cancer resection with natural orifice extraction is a safe and feasible minimally invasive surgery for patients suffering from rectal cancer as it encompasses considerable several advantages. Histological differentiation and T stage may serve as independent prognostic factors for 3-year overall survival and 3-year progression-free survival. Colorectal cancer is the fifth most commonly diagnosed cancer and the fifth leading cause of cancer death with nearly 3,763,000 patients diagnosed with colorectal cancer in China in 2015. This number is estimated to increase annually according to the latest cancer statistics in China 1. Surgical treatment modalities are a major role in the treatment of rectal cancer and is the cornerstone of curative treatment 2. With total mesorectal excision serving as the standard oncological approach, surgical methods for rectal cancer are gradually becoming enriched and more minimally invasive, and they are roughly divided into laparotomy, laparoscopic surgery, transanal endoscopic microsurgery and robotic surgery 3. By being able to filter physiological tremors, robotic rectal cancer surgery can distinctly reduce vascular nerve injury 4. However, the abdominal incision to extract the specimen

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical outcomes and prognostic factors of robotic assisted rectal cancer resection alone versus robotic rectal cancer resection with natural orifice extraction: a matched analysis

Liu

Luo

Wan

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…It combines the concept of incisionless surgery and laparoscopy to complete intra-abdominal procedures (including exploration, dissection, and resection of lesions) and uses a natural orifice as a delivery route for specimen extraction without laparotomy incision (13). Compared with other minimally invasive techniques, laparoscopic colorectal surgery with NOSE adopts a transabdominal approach, which is more in line with the surgeon's practice and is easier to operate (5, 14–16). Recently, several studies have reported that laparoscopic NOSE surgery results in significantly fewer perioperative complications and faster recovery of gastrointestinal function (4, 12).…”

Section: Introductionmentioning

confidence: 99%

Safety and Oncological Outcomes of Laparoscopic NOSE Surgery Compared With Conventional Laparoscopic Surgery for Colorectal Diseases: A Meta-Analysis

et al. 2019

View full text Add to dashboard Cite

Objective: To evaluate the safety and oncological outcomes of laparoscopic colorectal surgery using natural orifice specimen extraction (NOSE) compared with conventional laparoscopic (CL) colorectal surgery in patients with colorectal diseases. Methods: We conducted a systematic search of PubMed, EMBASE, and Cochrane databases for randomized controlled trials (RCTs), prospective non-randomized trials and retrospective trials up to September 1, 2018, and used 5-year disease-free survival (DFS), lymph node harvest, surgical site infection (SSI), anastomotic leakage, and intra-abdominal abscess as the main endpoints. Subgroup analyses were conducted according to the different study types [RCT and NRCT (non-randomized controlled trial)]. A sensitivity analysis was carried out to evaluate the reliability of the outcomes. RevMan5.3 software was used for statistical analysis. Results: Fourteen studies were included (two RCTs, seven retrospective trials and five prospective non-randomized trials) involving a total of 1,435 patients. Compared with CL surgery, the NOSE technique resulted in a shorter hospital stay, shorter time to first flatus, less post-operative pain, and fewer SSIs and total perioperative complications. Anastomotic leakage, blood loss, and intra-abdominal abscess did not differ between the two groups, while operation time was longer in the NOSE group. Oncological outcomes such as proximal margin [weighted mean difference [WMD] = 0.47; 95% confidence interval [CI] −0.49 to 1.42; P = 0.34], distal margin (WMD= −0.11; 95% CI −0.66 to 0.45; P = 0.70), lymph node harvest (WMD = −0.97; 95% CI −1.97 to 0.03; P = 0.06) and 5-year DFS (hazard ratio = 0.84; 95% CI 0.54–1.31; P = 0.45) were not different between the NOSE and CL surgery groups. Conclusions: Compared with CL surgery, NOSE may be a safe procedure, and can achieve similar oncological outcomes. Large multicenter RCTs are needed to provide high-level, evidence-based results in NOSE-treated patients and to determine the risk of local recurrence.

show abstract

“…The iatrogenic spread of tumours caused by compression during the process of removing specimens through the natural cavity has also been the focus of debate. According to literature reports [19][20] , the local tumour recurrence rate of patients after NOSE surgery is not higher than that after conventional laparoscopic surgery, and there is no literature report on patients with tumours implanted in the natural cavity after NOSE surgery. This is due to the sufficiently accurate assessment of tumour location, size, and depth of invasion using pelvic MRI or enhanced CT before surgery.…”

Section: Discussionmentioning

confidence: 99%

Clinical Application of the Reverse Puncture Technique for Total Laparoscopic Colorectal Resection with Natural Orifice Specimen Extraction

Kong

Xia

et al. 2020

Preprint

View full text Add to dashboard Cite

Objective To explore the feasibility, safety and short-term effects of the reverse puncture technique for total laparoscopic colorectal resection with natural orifice specimen extraction surgery (NOSES). Materials and Methods The clinical data of 28 patients undergoing total laparoscopic anterior resection with NOSE from July 2016 to July 2019 were retrospectively analysed. The operation was performed following the principle of total mesorectal excision. The reverse puncture technique was used to put the anvil into the proximal sigmoid colon. Then, intra-abdominal anastomosis of the proximal colon and distal rectum was carried out, and the short-term efficacy was evaluated. Results All 28 patients successfully underwent surgery, and the average operative time was 186 (160~220) min. The average time of anvil placement was 15 (12~18) min, the blood loss volume ranged from 60 to 150 ml, and the average length of hospital stay was 9.2 (7-11) d. All of the distal resection margins were confirmed to be negative by the pathological results. No surgery-associated complications, such as anastomosis stricture, leakage, or bleeding, were observed, and no local recurrence or metastasis occurred after 6 months of follow-up. Conclusion Reverse puncture for total laparoscopic colorectal resection with NOSE can avoid purse-string sutures under laparoscopy and avoid the auxiliary incision at the abdominal wall, which minimizes pain after operation. This approach is safe and feasible with a shortened hospital stay and rapid recovery, which results in good short-term clinical outcomes.

show abstract

Laparoscopy-Assisted Natural Orifice Specimen Extraction to Treat Tumors of the Sigmoid Colon and Rectum: The Short- and Long-Term Outcomes of a Retrospective Study

Cited by 17 publications

References 32 publications

Clinical outcomes and prognostic factors of robotic assisted rectal cancer resection alone versus robotic rectal cancer resection with natural orifice extraction: a matched analysis

Clinical outcomes and prognostic factors of robotic assisted rectal cancer resection alone versus robotic rectal cancer resection with natural orifice extraction: a matched analysis

Safety and Oncological Outcomes of Laparoscopic NOSE Surgery Compared With Conventional Laparoscopic Surgery for Colorectal Diseases: A Meta-Analysis

Clinical Application of the Reverse Puncture Technique for Total Laparoscopic Colorectal Resection with Natural Orifice Specimen Extraction

Contact Info

Product

Resources

About