PRIMARY EXPERIENCE OF NATURAL ORIFICE SPECIMEN EXTRACTION SURGERY (NOSES) FOR RECTAL CANCER

AIM: to demonstrate the first results of natural orifice specimen extraction surgery (NOSES) for rectal cancer.PATIENTS AND METHODS: in the period from June 2019 to October 2019 five NOSES for rectal cancer were performed in the hospital. The following factors were evaluated: age, gender, BMI, ASA, operation time, intraoperative blood loss, intraoperative and postoperative complications, duration of postoperative rehabilitation, need for narcotic analgesics.RESULTS: mean age of patients was 61.2 years. Mean BMI was 25.9 kg/m2 . Mean ASA score was 2. Mean operative time was 225 minutes. Mean intraoperative blood loss was 45 ml. One intraoperative complication occurred – defect of anastomosis in the point of crossing of 3 stapler sutures. One postoperative complication occurred – postoperative ileus. Narcotic analgesics were not used. Mean duration of postoperative stay was 9.8 days. The primary results demonstrate feasibility of NOSES for rectal cancer with adequate qualification of colorectal surgeon.CONCLUSION: NOSES is a promising technique for rectal cancer surgery. However, the further experience and randomized trials are required.

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Left colic artery preservation in laparoscopic rectal cancer surgery with transanal natural orifice specimen extraction and extracorporeal anvil placement

Techniques in Coloproctology ◽

10.1007/s10151-021-02519-3 ◽

2021 ◽

Author(s):

X. Huang

Keyword(s):

Rectal Cancer ◽

Cancer Surgery ◽

Rectal Cancer Surgery ◽

Colic Artery ◽

Natural Orifice ◽

Left Colic Artery ◽

Specimen Extraction ◽

Natural Orifice Specimen Extraction

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Role of robotic natural orifice specimen extraction surgery in colorectal neoplasms

Scientific Reports ◽

10.1038/s41598-021-89323-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hongliang Yao ◽

Tiegang Li ◽

Weidong Chen ◽

Sanlin Lei ◽

Kuijie Liu ◽

...

Keyword(s):

Colorectal Neoplasms ◽

Average Distance ◽

Neoadjuvant Chemoradiotherapy ◽

Operation Time ◽

Patient Characteristics ◽

Safe Procedure ◽

Natural Orifice ◽

Specimen Extraction ◽

Natural Orifice Specimen Extraction

AbstractNatural orifice specimen extraction surgery (NOSES) is especially suitable for colorectal surgery. Until now, most of the reports published were about laparoscopic NOSES, the reports about robotic NOSES are extremely rare. This study aims to explore the safety and feasibility of robotic NOSES for colorectal neoplasms. All patients underwent robotic NOSES from March 2016 to October 2019 in our hospital were enrolled for retrospective analysis. Clinicopathological data including patient characteristics, perioperative information and pathological information were collected and analyzed. According to the distance between tumor and anus or whether neoadjuvant chemoradiotherapy (nRCT) is performed, we grouped the cases and studied its influence on robotic NOSES. Also, we compared the previous reports on laparoscopic NOSES with our study and revealed advantages of robotic NOSES in terms of safety and feasibility. A total of 180 patients were enrolled. The average distance from the lower edge of the tumor to the anus was (8.64 ± 3.64) cm and maximum circumferential diameter (CDmax) of specimen was (3.5 ± 1.6) cm. In terms of safety, the average operation time, intraoperative blood loss, and postoperative hospital stay were (187.5 ± 78.3) min, (47.4 ± 34) mL, and (11.3 ± 7.5) days, respectively. In terms of feasibility, the average number of lymph node harvested was (14.8 ± 5). Robotic NOSES shows advantages in terms of safety and feasibility compared with laparoscopic NOSES. This procedure could not only be a safe procedure but also could achieve good oncological outcomes.

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