Comparative short- and long-term outcomes of three techniques of natural orifice specimen extraction surgery for rectal cancer

Guan, Xu; Lu, Zhao; Wang, Song; Liu, Enrui; Zhao, Zhixun; Chen, Haipeng; Zhang, Mingguang; Hu, Xiaoyan; Muhammad, Shan; Ma, Chenxi; Ma, Xiaolong; Huang, Haiyang; Jiang, Zheng; Liu, Zheng; Wang, Guiyu; Wang, Xishan

doi:10.1016/j.ejso.2020.06.023

Cited by 10 publications

(8 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study proved that compared with CL surgery, NOSES has the advantages of faster recovery of intestinal function, shorter postoperative length of stay, lower incidence of incisional infection, less postoperative pain, and better cosmetic effect. The results are similar to those reported in the past [ 1 , 3 , 4 , 7 ]. Additionally, transanal NOSES colorectal cancer resection achieved similar efficacy of radical resection to CL surgery, including adequate number of lymph node dissection, enough negative margin and similar long-term outcomes.…”

Section: Discussionsupporting

confidence: 92%

“…Natural orifice specimen extraction surgery (NOSES) in colorectal cancer has been explored in many clinical studies [ 1 , 2 ]. Compared with conventional laparoscopic (CL) surgery, NOSES reduces assisted incision and related postoperative pain and incisional complications as well as obtaining faster recovery and better cosmetic effects [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Short- and long-term outcomes as well as anal function of transanal natural orifice specimen extraction surgery versus conventional laparoscopic surgery for sigmoid colon or rectal cancer resection: a retrospective study with over 5-year follow-up

Zhang¹,

Li²,

Liu³

et al. 2022

wiitm

View full text Add to dashboard Cite

Introduction:To date, long-term safety including functional outcomes of transanal natural orifice specimen extraction surgery (NOSES) for colorectal cancer resection has not been confirmed. Aim: To explore the short-and long-term outcomes as well as anal function of transanal NOSES versus conventional laparoscopic surgery for sigmoid colon or rectal cancer resection. Material and methods: A retrospective review of data from a prospectively maintained database was performed to analyze the data of 69 patients who underwent transanal NOSES for sigmoid colon or rectal cancer resections and another 69 matched patients who underwent conventional laparoscopic (CL) surgery. Anal function of patients was evaluated using the Wexner fecal incontinence scale postoperatively. Results: Transanal NOSES resulted in faster recovery of intestinal function, shorter postoperative length of stay, less incisional pain, fewer postoperative complications and shorter scars than CL surgery (p < 0.05). The two groups had similar overall survival (p = 0.863) and disease-free survival (p = 0.961). Wexner scores of the NOSES group at 1, 3 and 6 months after surgery were higher than in the CL group (p < 0.05), and there was no difference between the two groups at 12, 18 and 24 months after surgery. Conclusions: Transanal NOSES achieves similar survival outcomes to CL surgery. Transanal NOSES has the advantages of faster recovery, shorter postoperative hospital stay, less incisional pain, shorter scars, etc. However, transanal NOSES can indeed impair anal function, needing more attention.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Short- and long-term outcomes as well as anal function of transanal natural orifice specimen extraction surgery versus conventional laparoscopic surgery for sigmoid colon or rectal cancer resection: a retrospective study with over 5-year follow-up

Zhang¹,

Li²,

Liu³

et al. 2022

wiitm

View full text Add to dashboard Cite

show abstract

“…The subgroup analysis demonstrated that there was no statistically signi cant difference in the complication rate among the three methods. In previous studies on laparoscopic NOSES endoscopic, there was no signi cant difference between anastomotic leakage, anastomotic bleeding, and abdominal abscess among the three methods [20]. These results implied that the complications were similar regardless of how the specimen was resected and removed.…”

Section: Discussionmentioning

confidence: 62%

“…These results implied that the complications were similar regardless of how the specimen was resected and removed. Therefore, when choosing from these three methods, tumor location should be prioritized over complications [20]. To reduce the risk of infection after NOSES, the international consensus of NOSES recommends that preventive antibiotics should be used before surgery, defecation preparation should be improved, intra-abdominal irrigation should be performed during surgery, a large amount of povidone-iodine and saline should be used for anal cleaning, translucent wound protectors should be used, and pelvic or abdominal drains should be used [3] , [21].…”

Section: Discussionmentioning

confidence: 99%

Robotic natural orifice specimen extraction surgery for colorectal cancer: an open-label, single-arm study

Zhong

Zhang

Luo

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Robotic natural orifice specimen extraction surgery (NOSES) is a minimally invasive surgery for colorectal cancer patients. As an emerging procedure, its safety and feasibility require thorough investigation. This study aimed to evaluate preliminary data and provide evidence for the therapeutic benefits and clinical applicability of robotic NOSES in colorectal cancer patients.Methods: This was an open-label single-arm study that recruited patients with colorectal cancer and treated them with robotic NOSES, which was performed by three methods of specimen extraction: a: transanal specimen eversion and extra-abdominal resection technique (EVER); b: translumenal specimen extraction and extra-abdominal resection technique (EXER); c: intra-abdominal specimen resection and translumenal extraction technique (IREX). The primary outcome was the complication rate. Between September 1, 2019, and May 31, 2020, 118 individuals were screened, and 101 were included in the intention-to-treat population. Lastly, after further evaluation, 91 individuals were included in the per-protocol population. Safety analyses were performed using SPSS 22.0 (SPSS, Chicago, USA). P-value < 0.05 was considered statistically significant.Results: A total of 118 patients were screened, and 101 were enrolled for the robotic NOSES. Ten patients switched to traditional robotic-assisted surgery. Hypertension [13 (14.29%)] was the most common comorbidity. The overall complication rate was 18.68%, and the most common complication was anastomotic fistula (B and C level) [8 (8.79%)]. There was no significant difference in complication rate among the three methods of specimen extraction in the subgroup analysis (P = 0.638).Conclusion: Robotic NOSES can provide feasibility for colorectal cancer patients to a certain extent. The most prevalent surgical complication of robotic NOSES for colorectal cancer patients was anastomotic fistula (B and C level) [8 (8.79%)].

show abstract

“…It is well known that a prolonged operative time is often accompanied by a prolonged anesthesia time and more blood loss and may lead to many adverse events (45), such as SSI, wound disruption, reoperation or transfusion. A prolonged operative time was demonstrated to be associated with an increased risk of POCs in our studies.…”

Section: Perioperative Factors (Operation Time and Antibiotic Prophyl...mentioning

confidence: 99%

Postoperative Complications of Free Flap Reconstruction in Moderate-Advanced Head and Neck Squamous Cell Carcinoma: A Prospective Cohort Study Based on Real-World Data

Wang

Wei

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundPostoperative complications (POCs) of moderate-advanced head and neck squamous cell carcinoma (HNSCC) after free flap reconstruction have received little attention. We investigated the risk factors that lead to POCs and their impact on management and prognosis.Patients and MethodsA single-center, prospective cohort study was conducted at Beijing Stomatological Hospital on primary HNSCC patients treated between 2015 and 2020.ResultsIn total, 399 consecutive HNSCC patients who underwent radical resection of the primary tumor and free flap reconstruction were enrolled in this study, 155(38.8%) experienced POCs. The occurrence of POCs directly led to worse short-term outcomes and poorer long-term overall survival (P=0.0056). Weight loss before the operation (P=0.097), Tumor site (P=0.002), stage T4b (P=0.016), an ACE-27 index of 2-3 (P=0.040), operation time≥8h (P=0.001) and Clindamycin as antibiotic prophylaxis (P=0.001) were significantly associated with POCs.ConclusionsThe occurrence of POCs significantly leads to worse short-term outcomes and increases the patients’ burden.

show abstract

Comparative short- and long-term outcomes of three techniques of natural orifice specimen extraction surgery for rectal cancer

Cited by 10 publications

References 13 publications

Short- and long-term outcomes as well as anal function of transanal natural orifice specimen extraction surgery versus conventional laparoscopic surgery for sigmoid colon or rectal cancer resection: a retrospective study with over 5-year follow-up

Short- and long-term outcomes as well as anal function of transanal natural orifice specimen extraction surgery versus conventional laparoscopic surgery for sigmoid colon or rectal cancer resection: a retrospective study with over 5-year follow-up

Robotic natural orifice specimen extraction surgery for colorectal cancer: an open-label, single-arm study

Postoperative Complications of Free Flap Reconstruction in Moderate-Advanced Head and Neck Squamous Cell Carcinoma: A Prospective Cohort Study Based on Real-World Data

Contact Info

Product

Resources

About