2018
DOI: 10.2147/ceg.s135331
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Natural orifice specimen extraction in colorectal surgery: patient selection and perspectives

Abstract: 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 minima… Show more

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Cited by 47 publications
(48 citation statements)
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“…In 1993, Franklin et al (10) were the first to publish a case of patient who underwent sigmoid resection with transrectal specimen extraction. In recent years, more and more people have noticed that NOSES is more minimally invasive than conventional laparoscopic surgery and has accelerated the postoperative recovery of patients (11)(12)(13). It has caused widespread concern in the treatment of colorectal cancer and could be the next step in minimizing minimally invasive surgery (1,5,14).…”
Section: Discussionmentioning
confidence: 99%
“…In 1993, Franklin et al (10) were the first to publish a case of patient who underwent sigmoid resection with transrectal specimen extraction. In recent years, more and more people have noticed that NOSES is more minimally invasive than conventional laparoscopic surgery and has accelerated the postoperative recovery of patients (11)(12)(13). It has caused widespread concern in the treatment of colorectal cancer and could be the next step in minimizing minimally invasive surgery (1,5,14).…”
Section: Discussionmentioning
confidence: 99%
“…Locally advanced tumor, acute bowel obstruction and perforation from cancer are not recommended to perform laparoscopy. Thirdly, NOSES also has specific indication requirements, including: the depth of tumor invasion should be T2 or T3, the CDmax of specimen should be less than 3 cm for transanal-NOSES and 3–5cm for transvaginal-NOSES, body mass index (BMI) should be less than 30 kg/m 2 for transanal-NOSES and less than 35 kg/m 2 for transvaginal-NOSES [14, 21]. Fourthly, NOSES is also recommended for benign tumors, Tis and T1 tumor when local excision is not indicated for whatever reasons.…”
Section: Indicationsmentioning
confidence: 99%
“…Therefore, the posterior colpotomy incision does not affect the sexual function and not increase the risk of bleeding. Currently, there are no complications related to the colpotomy incision reported in colorectal surgery [21].…”
Section: Technical Difficultymentioning
confidence: 99%
“…Several attempts have been described for optimizing outcomes after laparoscopic and robotic approaches. Natural orifice specimen extraction surgery (NOSES) has met with great interest among laparoscopic colorectal surgeons since it reduces trauma and wound infection and also minimizes postoperative pain . Compared with the traditional laparoscopic technique, better cosmetic results and lower rates of incisional hernia have been demonstrated .…”
mentioning
confidence: 99%