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

2020 ◽  
Author(s):  
Qi Kong ◽  
Yabin Xia ◽  
Hu Hao ◽  
Yan Jina ◽  
Longchao Wu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Colorectal Resection ◽  
Average Length ◽  
Resection Margins ◽  
Natural Orifice ◽  
Specimen Extraction ◽  
Short Term ◽  
Laparoscopic Colorectal Resection ◽  
Natural Orifice Specimen Extraction ◽  
Puncture Technique

Abstract 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.

scholarly journals The Comparison of Laparoscopic Colorectal Resection with Natural Orifice Specimen Extraction versus Mini-Laparotomy Specimen Extraction for Colorectal Tumours: A Systematic Review and Meta-Analysis of Short-Term Outcomes

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Jun He ◽  
Jun-Feng Hu ◽  
Shu-Xian Shao ◽  
Hai-Bo Yao ◽  
Xiu-Feng Zhang ◽  
...  
Keyword(s):  
Colorectal Resection ◽  
Weighted Mean Difference ◽  
Postoperative Recovery ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Natural Orifice ◽  
Specimen Extraction ◽  
Short Term ◽  
Natural Orifice Specimen Extraction ◽  
Colorectal Tumours

Aim. The aims of this study were to compare the short-term outcomes of natural orifice specimen extraction surgery (NOSES) and conventional laparoscopic surgery (CLAPS) for colorectal tumours and to evaluate the safety and feasibility of NOSES in colorectal resection. Methods. A literature review was performed on the PubMed, Cochrane Library, and Embase databases up to March 2019. Papers conforming to the inclusion criteria were used for further analysis. The short-term outcomes included intraoperative outcomes and postoperative recovery results. The weighted mean difference (WMD) was calculated for continuous outcomes and odds ratio (OR) for dichotomous results. Study quality was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS) or the 6-item Jadad scale. Results. Eight studies comprising 686 patients met the inclusion criteria. Compared with CLAPS, NOSES had more advantages in terms of postoperative complications, postoperative pain, recovery of gastrointestinal function, duration of hospital stay, and cosmetic results. The lymph nodes harvested and intraoperative blood loss in NOSES were comparable with CLAPS; however, a prolonged operative time was observed in NOSES. Conclusions. NOSES was shown to be a safe and viable alternative to CLAPS in colorectal oncology in terms of short-term results. Further long-term and randomized trials are required.

Appraisal and Consideration of Natural Orifice Specimen Extraction Surgery in Colorectal Cancer

Nano LIFE ◽  
2019 ◽  
Vol 09 (04) ◽  
pp. 1930001
Author(s):  
Zheng-Wei Fu ◽  
Li-Xia Wang ◽  
Hai-Yan Ge
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Colectomy ◽  
Endoscopic Surgery ◽  
Surgical Approach ◽  
Oncologic Outcomes ◽  
Natural Orifice ◽  
Specimen Extraction ◽  
Short Term ◽  
Natural Orifice Specimen Extraction ◽  
The Times

Although laparoscopic colectomy shows superior short-term outcomes and similar oncologic outcomes in comparison to conventional open colectomy, incision-related complications have weakened its advantages. The natural orifice transluminal endoscopic surgery (NOTES) has been considered as the most perfect surgical approach. However, monumental technical hurdles have precluded widely adoption of this technique. As a transient mode, the natural orifice specimen extraction surgery (NOSES) emerges as the times require. Although it is accepted by surgeons for the treatment of colorectal cancer, there are still many disputes that need to be solved.

scholarly journals Short-term efficacy of natural orifice specimen extraction surgery for low rectal cancer

2019 ◽  
Vol 7 (2) ◽  
pp. 122-129 ◽  
Author(s):  
Jun-Hong Hu ◽  
Xing-Wang Li ◽  
Chen-Yu Wang ◽  
Jun-Jie Zhang ◽  
Zheng Ge ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Low Rectal Cancer ◽  
Natural Orifice ◽  
Specimen Extraction ◽  
Short Term ◽  
Natural Orifice Specimen Extraction ◽  
Term Efficacy

scholarly journals Minimally invasive right colectomy with transrectal natural orifice extraction: could this be the next step forward?

2020 ◽  
Vol 24 (11) ◽  
pp. 1197-1205
Author(s):  
C.-C. Cheng ◽  
Y.-R. Hsu ◽  
Y.-J. Chern ◽  
W.-S. Tsai ◽  
H.-Y. Hung ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hospital Stay ◽  
Surgical Outcomes ◽  
Colon Surgery ◽  
Right Hemicolectomy ◽  
Natural Orifice ◽  
Specimen Extraction ◽  
Conventional Surgery ◽  
Short Term ◽  
Mini Laparotomy

Abstract Background The transvaginal natural orifice specimen extraction (NOSE) approach for right-side colon surgery has been proven to exhibit favorable short-term outcomes. However, thus far, no study has reported the advantages of transrectal NOSE for right-side colon surgery. The aim of this study was to compare the technical feasibility, safety, and short-term outcomes of minimally invasive right hemicolectomy using the transrectal NOSE method and those of conventional mini-laparotomy specimen extraction. Methods A study was conducted on consecutive patients who had minimally invasive right hemicolectomy either for malignancy or benign disease at Chang Gung Memorial Hospital, Linkou, Taiwan, between January 2017 and December 2018. The patients were divided into two groups: conventional surgery with specimen extraction using mini-laparotomy and NOSE surgery. Surgical outcomes, including complications, postoperative short-term recovery, and pain intensity, were analyzed. Results We enrolled 297 patients (151 males, mean age 64.9 ± 12.8 years) who had minimally invasive right hemicolectomy. Of these 297 patients, 272 patients had conventional surgery with specimen extraction through mini-laparotomy and 25 patients had NOSE surgery (23 transrectal, 2 transvaginal). The diagnosis of colon disease did not differ significantly between the conventional and NOSE groups. Postoperative morbidity and mortality rates were comparable. The postoperative hospital stay was significantly (p = 0.004) shorter in the NOSE group (median 5 days, range 3–17 days) than in the conventional group (median 7 days, range 3–45 days). Postoperative pain was significantly (p = 0.026 on postoperative day 1 and p = 0.002 on postoperative day 2) greater in the conventional group than in the NOSE group. Conclusions NOSE was associated with acceptable short-term surgical outcomes that were comparable to those of conventional surgery. NOSE results in less postoperative wound pain and a shorter hospital stay than conventional surgery. Larger studies are needed

scholarly journals A Case Series of Laparoscopic Colorectal Resections with Natural Orifice Specimen Extraction and Systematic Literature Review

2021 ◽  
Vol 07 (03) ◽  
pp. e203-e208
Author(s):  
Nasir Zaheer Ahmad ◽  
Ray Swayamjoti ◽  
Karen Flashman ◽  
Syed Abul Hassan Naqvi ◽  
Jim Khan
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Meta Analysis ◽  
Operating Time ◽  
Case Series ◽  
Natural Orifice ◽  
Specimen Extraction ◽  
Short Term ◽  
Abdominal Incision ◽  
Natural Orifice Specimen Extraction

Abstract Background Minimal access surgery is associated with improved cosmetic and other short-term outcomes. Conventionally, an abdominal incision is made for specimen extraction. We assessed the feasibility of specimen extraction through one of the natural orifices and analyzed its impact on short-term outcomes. Methods A prospectively collected data were reviewed on consecutive patients who underwent natural orifice specimen extraction (NOSE) after laparoscopic colorectal surgery. The results were compared with a matched group who had transabdominal extraction (TAE) of the specimens. A systematic literature review was performed to compare our results. Results The combined median operating time for right and left colectomies was significantly higher in the NOSE group as compared with TAE group (260 vs. 150). There was no mortality in either group and no conversions to TAE in the NOSE group. No local metastasis or major iatrogenic injuries were reported at the time of retrieval. The results were comparable to those of a meta-analysis of randomized controlled trials. Conclusion The results of NOSE are comparable to those of TAEs. The absence of a minilaparotomy for specimen extraction may lead to a speedy recovery and better cosmesis.

scholarly journals Laparoscopic colorectal resection: short-term outcomes after 60 procedures - a single center initial experience

2020 ◽  
Vol 77 (2) ◽  
pp. 220-224
Author(s):  
Miljan Ceranic ◽  
Stojan Latincic ◽  
Ognjan Skrobic ◽  
Dragan Gunjic ◽  
Jovica Vasiljevic ◽  
...  
Keyword(s):  
Lymph Node ◽  
Hospital Stay ◽  
Colorectal Resection ◽  
Colorectal Polyps ◽  
University Hospital ◽  
Resection Margins ◽  
Laparoscopic Colorectal Resection ◽  
Oncologic Surgery ◽  
Invasive Approach ◽  
Positive Effects

Background/Aim. Laparoscopic colorectal surgery is now widely accepted surgical method in the treatment of malignant and benign colorectal diseases. It is getting constantly more supporters due to its positive effects on enhanced patient recovery. The aim of this study was to determine the safety of minimally invasive approach as well as perioperative data, oncologic results and postoperative data. Methods. Prospective observational cohort clinical study was carried out at the Department for Colorectal and Pelvic Oncologic Surgery, First Surgical University Hospital, Clinical Center of Serbia, Belgrade. We analyzed demographics records concerning the type of surgery, clinicopathological features and oncological data for all operated patients. Records on early postoperative follow-up were also evaluated. Results. Laparoscopic colorectal resection was performed in 60 patients. Mean age of patients was 65 (29?87) years. Majority of patients were man, 37 (62%) of them. The most common indication was colorectal cancer (43 patients, 71.6%); 12 (20%) patients were operated due to the colorectal polyps unfitted for colonoscopic resection and 5 (8.3%) were operated due to Crohn?s disease. Average number of lymph node harvested in patients with colorectal carcinoma was 22.5 (6?52). We achieved negative resection margins in all patients operated due to carcinoma. Mean duration of hospital stay was 5 (4?12) days. Postoperative complications were encountered in 5 (8.3%) patients. Overall mortality rate was 1.7% (1 patient died due to thromboembolism). Conclusion. This study showed that initiation of laparoscopic colorectal resection is feasible and safe with short hospital stay, adequate oncologic resection and number of lymph node harvested.

Sign in / Sign up

Export Citation Format

Share Document