Short-term and oncological outcomes of natural orifice specimen extraction surgery (NOSES) for colorectal cancer in China: a national database study of 5055 patients

Guan, Xu; Hu, Xiaoyan; Jiang, Zheng; Ye, Wei; Sun, Dongfa; Wu, Miao; Zhou, Haitao; Yao, Hongliang; Song, Junmin; Wang, Guiyu; Hu, Junhong; Ren, Mingyang; Xu, Qing; Cai, Jun; Peng, Jian; Ma, Dan; Yangchun, Zheng; He, Qin; Jiang, Bo; Wang, Zejun; Li, Taiyuan; Yan, Su; Yao, Xueqing; Li, Tiegang; Xiong, Zhiguo; Chi, Pan; Kang, Liang; Yu, Gang; Deng, Xiaodong; Zhang, Hong; Xie, Mingxing; Wei, Jianbao; Gong, Hang; Sun, Xuejun; Zang, Weidong; Song, Yi; He, Ping; Wen, Zhengqi; Zhang, Chunxu; Wang, Yusheng; Chen, Yinggang; Xie, Guangwei; Li, Mingzhang; Yu, Shaojun; Liu, Haiying; Pu, Min; Fu, Chuangang; Wang, Xishan

doi:10.1016/j.scib.2022.05.014

Cited by 24 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, a multicenter NOSES data platform has been established in China. Seventy-nine centers with more than 5000 cases were included, and the data have been published recently [ 20 , 21 ].…”

Section: A Scarless Technique—natural Orifice Specimen Extraction Sur...mentioning

confidence: 99%

Is natural orifice specimen extraction surgery the future direction of minimally invasive colorectal surgery?

Zhang¹,

Liu²,

Wang³

2022

Surgery Open Science

Self Cite

View full text Add to dashboard Cite

Section: A Scarless Technique—natural Orifice Specimen Extraction Sur...mentioning

confidence: 99%

Is natural orifice specimen extraction surgery the future direction of minimally invasive colorectal surgery?

Zhang¹,

Liu²,

Wang³

2022

Surgery Open Science

Self Cite

View full text Add to dashboard Cite

“…There were also signi cant differences in complications between EXSI and the EVER group (10.6% vs. 26.1%, P = 0.028), this may be because the anastomotic site of the EVER group is closer to the anus and the number of patients enrolled was too small. However, in our center's large sample data, 3651 patients with rectal cancer who underwent natural ori ce specimen extraction surgery (NOSES) with transanal specimen extraction, the postoperative complication rate was 15.3% [13]. However, Wolthuis et al conducted a randomized controlled study to compare the early complications after NOSES without auxiliary abdominal incision and traditional laparoscopic surgery and found that the postoperative complication rate of each group was 15% (3/20), but the NOSES group had less postoperative pain and lower analgesic requirements [19].…”

Section: Discussionmentioning

confidence: 96%

“…Technological advances and innovations in colorectal surgery over the past few decades have not only reduced abdominal surgical incisions but also avoided specimen extraction sites [13]. However, there are still only few relevant studies on whether different specimen extraction methods affect the short-term curative effect and stoma recovery of patients.…”

Section: Discussionmentioning

confidence: 99%

Do different methods of specimen extraction in laparoscopic low rectal cancer surgery affect loop ileostomy closure?

Chen

Huang

Yang

et al. 2023

Preprint

View full text Add to dashboard Cite

Introduction: The aim of this study was to compare whether laparoscopic low rectal cancer surgery with three different specimen extraction methods affects loop ileostomy closure. Materials and methods A consecutive series of patients with low rectal cancer who underwent laparoscopic low anterior resection plus protective loop ileostomy (LAR-PLI) were enrolled. Three main techniques, namely specimen extraction through auxiliary incision (EXAI), specimen extraction through stoma incision (EXSI), and specimen eversion and extra-abdominal resection (EVER), were employed. The postoperative outcomes of the three techniques and the impact on loop ileostomy closure were compared. Results In all, 254 patients were enrolled in this study: 104 (40.9%) in the EXAI group, 104 (40.9%) in the EXSI group, and 46 (18.1%) in the EVER group. For primary surgery, EXAI group had significantly longer operative time (P < 0.001), more intraoperative bleeding (P < 0.001), longer length of abdominal incision (P༜0.001), longer time to first flatus (P < 0.001), longer time to first defecation (P < 0.001), longer time to first eat (P < 0.001), and longer postoperative hospital stays (P = 0.005) than the EXSI and EVER groups. The primary postoperative complication rate in the EXAI and EVER group was significantly higher than in the EXSI group (P = 0.005). In loop ileostomy closure, EXAI group had significantly longer operative time (P = 0.001), more bleeding volume and longer postoperative hospital stays (P < 0.001) than the EXSI and EVER groups. Conclusions All three techniques of LAR-PLI for low rectal cancer were safe and feasible, but specimen extraction via EXAI had no advantages in terms of early postoperative recovery and loop ileostomy closure.

show abstract

“…The minimally invasive natural orifice specimen extraction surgery (NOSES) has tackled this complication. Moreover, NOSES can provide good near-term outcomes while satisfying the need for radical tumor treatment ( 12 – 14 ). The combination of surgical robots and NOSES can bring incredible benefits to colorectal cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Comparison of transabdominal wall specimen retrieval and natural orifice specimen extraction robotic surgery in the outcome of colorectal cancer treatment

Ziwen²,

Zhong³

et al. 2023

Front. Surg.

View full text Add to dashboard Cite

BackgroundNatural orifice specimen extraction surgery (NOSES), as a new star of minimally invasive techniques, has been increasingly favored and promoted in the field of surgery around the world. Most previous studies were comparative studies of laparoscopic NOSES and conventional laparoscopic surgery. However, there is little research on comparing robotic colorectal cancer NOSES with conventional robotic-assisted colorectal cancer resection surgery.Participant and methodsThis study is a retrospective study of propensity score matching (PSM). This study included Ninety-one propensity score-matched pairs of the participant who had undergone robotic colorectal cancer resection surgery at our center between January 2017 and December 2020. The covariates used in the propensity score included gender, age, BMI, ASA score, maximum tumor diameter, the tumor's height from the anal verge, histological differentiation, AJCC stage, T stage, N stage, and history of previous abdominal surgery. The outcome measurement criteria included postoperative complications, inflammatory response, pelvic floor function, anal function, cosmetic outcome, quality of life, disease-free survival (DFS), and overall survival (OS).ResultsThe robotic NOSES group had faster recovery time from gastrointestinal function (P = 0.014), shorter abdominal incision length (P < 0.001), less pain (P < 0.001), less additional analgesia required (P < 0.001), and lower postoperative indicators of white blood cell count (P < 0.001) and C-reactive protein content compared to the robotic-assisted resection surgery (RARS) group (P = 0.035). Additionally, the robotic NOSES group had significantly better body imagery (P < 0.001), cosmetic scores (P < 0.001), somatic function (P = 0.003), role function (P = 0.039), emotional function (P = 0.001), social function (P = 0.004), and overall function (P < 0.001) than the RARS group. The two groups demonstrated no significant difference between DFS and OS.ConclusionRobotic colorectal cancer NOSES is a safe and feasible minimally invasive procedure and offers shorter abdominal incisions, less pain, less surgical stress response, and better postoperative quality of life. Therefore, this technique can be further promoted for colorectal cancer patients eligible for NOSES.

show abstract

Short-term and oncological outcomes of natural orifice specimen extraction surgery (NOSES) for colorectal cancer in China: a national database study of 5055 patients

Cited by 24 publications

References 14 publications

Is natural orifice specimen extraction surgery the future direction of minimally invasive colorectal surgery?

Is natural orifice specimen extraction surgery the future direction of minimally invasive colorectal surgery?

Do different methods of specimen extraction in laparoscopic low rectal cancer surgery affect loop ileostomy closure?

Comparison of transabdominal wall specimen retrieval and natural orifice specimen extraction robotic surgery in the outcome of colorectal cancer treatment

Contact Info

Product

Resources

About