Short-term efficacy of transvaginal specimen extraction for right colon cancer based on propensity score matching: A retrospective cohort study

Aim: Laparoscopic anterior resection with natural orifice specimen extraction (NOSE) has favourable short-term outcomes. However, NOSE is rarely adopted for left hemicolectomy procedures. This study aimed to review the feasibility, safety and short-term outcomes of transrectal NOSE in patients undergoing laparoscopic left hemicolectomy. Method: All consecutive patients who underwent laparoscopic left hemicolectomy surgery with transrectal NOSE in a single institution between January 2018 and December 2020 were reviewed. Transrectal NOSE was performed with an enterotomy at the upper rectum. The specimen was brought out via a transanal endoscopic microsurgery scope inserted through the anus. A supplementary video demonstrates this technique. Surgical outcomes, including complications, postoperative short-term recovery and the level of pain intensity, are presented.Results: Twenty patients were reviewed. There were no immediate postoperative complications and no wound infections in these patients. The average time to tolerate a soft diet was 3.6 days, and the average postoperative hospital stay was 4.5 days. The average score on the numerical rating scale of postoperative pain was 3.0 on postoperative day 1. The median follow-up time was 23.5 months. Conclusion:Laparoscopic left hemicolectomy with transrectal NOSE is a safe and feasible procedure that leads to early postoperative recovery and a short hospital stay.

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“…were found in the NOSE group [14]. Smaller wounds cause less pain, which translates to less postoperative opioid use.…”

Section: Ta B L E 1 Clinical Characteristics and Pathological Data Of Patientsmentioning

confidence: 77%

Transrectal natural orifice specimen extraction in left hemicolectomy for tumours around the splenic flexure: Old wine in new bottles

et al. 2021

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“…In total, 2378 patients had resection for colorectal lesions; 1079 had 1 3 NOSE and 1299 had CLS. Fifteen studies compared the surgical outcomes for malignant colorectal lesions [23,[28][29][30][31][32][33][36][37][38][39][40][41][42][43], four were done on benign diseases such as endometriosis [35], diverticulitis, and benign colorectal tumours [24][25][26], and two discussed both malignant and benign diseases [27,34]. The majority of the studies were conducted in China (n = 10), with others conducted in Korea (n = 3), France (n = 2), Japan, Belgium, Hungary, Switzerland, and the United States of America (USA).…”

Section: Resultsmentioning

confidence: 99%

Colorectal resection via natural orifice specimen extraction versus conventional laparoscopic extraction: a meta-analysis with meta-regression

Chin

Decruz

et al. 2020

Tech Coloproctol

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Background Studies have shown differences in postoperative outcomes between two minimally invasive extraction methods for colorectal lesions-natural orifice specimen extraction surgery (NOSES) and conventional laparoscopic surgery (CLS). The aim of this study was to discover the major differences in NOSES and CLS to refine current practice. Methods Electronic databases were searched for articles comparing NOSES and CLS from inception till March 2020. Weighted mean differences (WMD) and odds ratio (OR) were estimated for continuous and dichotomous outcomes, respectively. Summary statistics were calculated using the DerSimonian and Laird random effects. Results Twenty-one studies (15 on malignant disease, 4 on benign disease, 2 on both) were included in this meta-analysis, totalling 2378 patients (1079 NOSE, 1299 CLS). NOSE was associated with decreased: intraoperative bleeding

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“…With regard to transvaginal NOSES, the posterior vaginal fornix was cut open, which inevitably led to changes in vaginal structure, so postoperative wound healing, incision infection, tumor implantation and pelvic floor function were also the focus of this study. 11,12 Peri et al 13 studied 100 patients who underwent laparoscopic radical nephrectomy (LRN)+ transvaginal NOSES. The results showed that no one case of vaginal wound infection and poor healing, which was consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

A new and practical surgical technique of transvaginal natural orifice specimen extraction surgery (NOSES) in laparoscopic nephroureterectomy—an initial clinical experience

Zhao

Yang

et al. 2021

Journal of Surgical Oncology

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Short-term efficacy of transvaginal specimen extraction for right colon cancer based on propensity score matching: A retrospective cohort study

Cited by 24 publications

References 17 publications

Transrectal natural orifice specimen extraction in left hemicolectomy for tumours around the splenic flexure: Old wine in new bottles

Transrectal natural orifice specimen extraction in left hemicolectomy for tumours around the splenic flexure: Old wine in new bottles

Colorectal resection via natural orifice specimen extraction versus conventional laparoscopic extraction: a meta-analysis with meta-regression

A new and practical surgical technique of transvaginal natural orifice specimen extraction surgery (NOSES) in laparoscopic nephroureterectomy—an initial clinical experience

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