Complete laparoscopic resection of the rectum using natural orifice specimen extraction

Abstract

Complete laparoscopic anterior resection using NOSE does not require any incision and has excellent cosmetic properties, with mitigated postoperative pain.

Laparoscopic resection with natural orifice specimen extraction versus conventional laparoscopy for colorectal disease: a meta-analysis

“…With regard to the result of less postoperative pain of NOSE, whether the anesthesia method (general anesthesia and epidural anesthesia) may be a potential factor to affect pain perception scale after surgery is not known. In our meta-analysis, only the study by Hisada et al [26] definitely recommended laparoscopic anterior resection with NOSE after epidural anesthesia. Although VAS was not used to evaluate postoperative pain in the study of Hisada et al [26], the NOSE group showed a significant decrease of postoperative use of analgesia and pain period (analgesia use 1.85±1.8 times versus 5.89±2.86 times, p<0.01; pain period 1.9±1.9 days versus 3.43±1.41 days, p<0.01).…”

“…In our meta-analysis, only the study by Hisada et al [26] definitely recommended laparoscopic anterior resection with NOSE after epidural anesthesia. Although VAS was not used to evaluate postoperative pain in the study of Hisada et al [26], the NOSE group showed a significant decrease of postoperative use of analgesia and pain period (analgesia use 1.85±1.8 times versus 5.89±2.86 times, p<0.01; pain period 1.9±1.9 days versus 3.43±1.41 days, p<0.01). In the future, which anesthesia method can be more appropriate for colorectal NOSE in reducing postoperative pain that should be explored?…”

“…Postoperative complications are crucial factors that aid evaluation the short-term safety of a new method. Six included studies [22,24,[26][27][28][29] mentioned the prevalence of wound infection in the CL group. In 53.85 % of subjects, wound infection was the main postoperative complication in the CL group.…”

“…After reading titles and abstracts, 21 studies were shown to be pertinent. Finally, nine studies [16,[22][23][24][25][26][27][28][29] were found to fit the inclusion criteria after reading the full text (Fig. 1).…”

“…Seven studies [22][23][24][26][27][28][29] reported the operation time. The NOSE group showed a significantly longer operation time than the CL group (WMD = 20.97 min, 95 % CI [4.33, 37.62], p=0.01).…”