How do patients score cosmesis after laparoscopic natural orifice specimen extraction colectomy?

Wolthuis, Albert; Meuleman, Christel; Tomassetti, Carla; D’Hooghe, Thomas; Fieuws, Steffen; Overstraeten, Anthony de Buck van; D’Hoore, André

doi:10.1111/codi.12885

Cited by 24 publications

(18 citation statements)

References 25 publications

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“…Wolthuis et al [31] described in detail how patients score for cosmetic results after laparoscopic NOSE colectomy. In our meta-analysis, three studies [22,24,27] reported the cosmetic result after surgery using a scale ranging from 1 (poor) to 10 (excellent).…”

Section: Cosmetic Resultsmentioning

confidence: 99%

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

Huang

Gao

et al. 2015

Int J Colorectal Dis

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Section: Cosmetic Resultsmentioning

confidence: 99%

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

Huang

Gao

et al. 2015

Int J Colorectal Dis

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“…Superior outcomes in terms of postoperative pain control, time to first bowel function, hospital length of stay, reduced incisional complications, and improved cosmesis have been demonstrated. 17 , 19 – 22 It should be noted that studies demonstrating these superior outcomes had strict inclusion criteria. Careful examination of patient characteristics in these studies can be used to extrapolate themes that can aid in selecting patients who can most benefit from NOSE in colorectal surgery.…”

Section: Potential Benefitsmentioning

confidence: 99%

“…Improved cosmesis has been assumed to be superior in patients undergoing NOSE compared to conventional specimen extraction; however, Wolthuis et al 22 investigated this more objectively in a case-matched series. They found that cosmesis was significantly better in the NOSE group as evaluated by a body image questionnaire and the Patient Scar Assessment Questionnaire.…”

Section: Potential Benefitsmentioning

confidence: 99%

Natural orifice specimen extraction in colorectal surgery: patient selection and perspectives

Izquierdo¹,

Unal²,

Marks³

2018

CEG

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Over the past 30 years, colorectal surgery has evolved to include minimally invasive surgical techniques. Minimally invasive surgery is associated with reduced postoperative pain, reduced wound complications, earlier return of bowel function, and possibly shorter length of hospital stay. These benefits have been attributed to a reduction in operative trauma compared to open surgery. The need to extract the specimen in colorectal operations through a “mini-laparotomy” can negate many of the advantages of minimally invasive surgery. Natural orifice specimen extraction (NOSE) is the opening of a hollow viscus that already communicates with the outside world, such as the vagina or distal gastrointestinal tract, in order to remove a specimen. The premise of this technique is to reduce the trauma required to remove the specimen with the expectation that this may improve outcomes. Reduction in postoperative analgesic use, quicker return of bowel function, and shorter length of hospital stay have been observed in colorectal operations with NOSE compared to conventional specimen extraction. While the feasibility of NOSE has been demonstrated in colorectal surgery, failures of this technique have also been described. Selection of patients who can successfully undergo NOSE needs further investigation. This review aims to guide surgeons in appropriately selecting patients for NOSE in colorectal surgery. Patient and specimen characteristics are reviewed in order to define patient populations in which NOSE is likely to be successful. Randomized trials comparing NOSE to conventional specimen extraction in colorectal surgery tend to enroll patients with favorable characteristics (body mass index <30, American Society of Anesthesiologists class ≤3, specimen diameter <6.5 cm) and demonstrate improved outcomes. Adopters of NOSE should restrict using this technique to the populations in which feasibility has been defined in the literature. Wider application to other populations, particularly patients with body mass index >30 and those with significant comorbidities, requires further study.

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“…[3][4][5] NOSES surgery has several distinct advantages as a result of its dedication for extremely minimal invasiveness based on a strict principle of contamination-free surgical manipulations. 2,6,7 Compared with laparoscopy-assisted surgery, patients receiving NOSES tend to experience an increased rate of comfortability 8 and a comparable frequency of complications with a shortened time for recovery and hospital stay. 7,9−11 However, improper application of NOSES for patients with upper RC may led to complications such as bacterial contamination and anastomotic bleeding and leak.…”

Section: Introductionmentioning

confidence: 99%

A nomogram for predicting feasibility of laparoscopic anterior resection with trans-rectal specimen extraction (NOSES) in patients with upper rectal cancer

Zhang

Zhu

Zhang

et al. 2021

Preprint

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BackgroundLaparoscopic anterior resection with trans-rectal specimen extraction (NOSES) has been demonstrated as a safe and effective technique in selected patients with upper rectal cancer (RC). However, improper selection of RC candidates for NOSES may lead to complications such as bacteria contamination and anastomotic leak. Unfortunately, no tools are available for evaluating the risk and excluding improper cases before surgery. This study aims to investigate independent clinical-pathological predictors for selection of candidates for NOSES surgery in upper RC and to develop a validated scoring nomogram to facilitate clinical decision making.MethodsThe study was performed at Shanghai East hospital, a tertiary medical center and teaching hospital. A consecutive and eligible serial of 111 patients with upper RC underwent elective laparoscopic anterior resection with or without NOSES between February and October of 2017. Multivariate analyses were performed to compare characteristics between the two surgical techniques. Odds ratios (OR) were determined by logistic regression analyses to identify and quantify the ability of predictors for selection of NOSES. The nomogram was constructed and characterized by c-index, calibration, bootstrapping validation, ROC curve analysis, and decision curve analysis.ResultsUpper RC patients with successful NOSES tended to be featured with female gender, negative preoperative CEA/CA19-9, decreased mesorectum length (MRL)，ratio of diameter (ROD) and ratio of area (ROA) values, while no significant correlations were observed with age, body mass index (BMI), tumor location, and tumor-related biological characteristics (ie., vascular invasion, lymph node count, TNM stages). The nomogram incorporating three independent preoperative predictors including gender, CEA status and ROD achieved a high c-index of 0.814 and considerable reliability, accuracy and clinical net benefit.ConclusionsNOSES for patients with upper RC is multifactorial. The first nomogram is useful for proper patient selection in the future.

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How do patients score cosmesis after laparoscopic natural orifice specimen extraction colectomy?

Cited by 24 publications

References 25 publications

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

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

Natural orifice specimen extraction in colorectal surgery: patient selection and perspectives

A nomogram for predicting feasibility of laparoscopic anterior resection with trans-rectal specimen extraction (NOSES) in patients with upper rectal cancer

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