Natural Orifice Specimen Extraction Surgery Versus Conventional Laparoscopic-Assisted Resection in the Treatment of Colorectal Cancer: A Propensity-Score Matching Study

Overview

Journal Cancer Manag Res

Publisher Dove Medical Press

Specialty Oncology

Date 2021 Mar 17

PMID 33727861

Citations 14

Authors

Qingchao Tang

Yihao Zhu

Huan Xiong

Xiangzong Sheng

Zhiqiao Hu

Hanqing Hu

Rui Huang

Qian Zhang

Ziming Yuan

Lei Xie

Zhifeng Gao

Yuliuming Wang

Guiyu Wang

Xishan Wang

Affiliations

Soon will be listed here.

Abstract

Background: Natural orifice specimen extraction surgery (NOSES) has been successfully applied to the treatment of gastric, colorectal cancer (CRC). However, the development of NOSES is still in the exploratory stage, and there is still no strong evidence-based medical evidence.

Patients And Methods: From January 2013 to June 2017, consecutive patients with colorectal cancer who underwent transluminal resection, anastomosis, and specimen extraction and those who underwent conventional laparoscopic resection were enrolled. Propensity score matching was used to align clinicopathological features between the two groups.

Results: A total of 372 patients were eventually included in this study, 186 in each group. According to perioperative information and postoperative follow-up in both groups, the NOSES group had less blood loss (P = 0.011), shorter time to recovery of gastrointestinal function (P < 0.001), shorter postoperative hospital stay (P = 0.037). The NOSES group had fewer postoperative analgesics (P < 0.001), lower postoperative pain scores (P < 0.001), and lower incidence of postoperative complications (P = 0.017). Compared with the LA (laparoscopic) group, the NOSES group had better physical function (P<0.05), role function (P<0.001), emotional function (P<0.001) and global health status than LA group, while symptoms such as pain (P<0.001), insomnia (P<0.001), constipation (P<0.001) and diarrhea (P<0.05) were less severe in the NOSES group. In addition, the NOSES group had higher body image scores. Overall survival (OS) and disease-free survival (DFS) were not significantly different between the two groups.

Conclusion: For surgical treatment of colorectal cancer, NOSES has advantages in reducing postoperative pain, recovery of gastrointestinal function, postoperative quality of life, and improving patients' satisfaction with abdominal wall aesthetics. There was no difference in long-term survival between NOSES and conventional laparoscopic surgery.

Citing Articles

Reduced-port laparoscopic right colonic resection with D3 lymph node dissection and transvaginal specimen extraction (NOSES VIIIa) for right colon cancer: clinical features.

Efetov S, Cao Y, Panova P, Khlusov D, Shulutko A Tech Coloproctol. 2024; 29(1):34.

PMID: 39714748 DOI: 10.1007/s10151-024-03055-6.

Effects of tattoos on the aesthetic appreciation of human stimuli as influenced by expertise, tattoo status, and age reflecting internalized social norms.

Weiler S, Duer C, Kramer D, Jacobsen T PLoS One. 2024; 19(12):e0313940.

PMID: 39661597 PMC: 11633991. DOI: 10.1371/journal.pone.0313940.

Advancing mid-rectal cancer surgery: Unveiling the potential of natural orifice specimen extraction surgery in comparison to conventional laparoscopic-assisted resection.

Muhammad S, Jiang Z, Fan T, Tang Q, Hai Y, Ehsan S Cancer Rep (Hoboken). 2024; 7(5):e2003.

PMID: 38703000 PMC: 11069103. DOI: 10.1002/cnr2.2003.

Robotic natural orifice specimen extraction surgery I-type F method conventional robotic resection for lower rectal cancer.

Tao F, Liu D, He P, Luo X, Xu C, Li T World J Gastrointest Surg. 2023; 15(10):2142-2153.

PMID: 37969697 PMC: 10642453. DOI: 10.4240/wjgs.v15.i10.2142.

Comparison of robotic-assisted and laparoscopic-assisted natural orifice specimen extraction surgery in short-terms outcomes of middle rectal cancer.

Ye S, Yu H, Liu D, Lu W, Wu C, Xu H World J Surg Oncol. 2023; 21(1):196.

PMID: 37403084 PMC: 10318637. DOI: 10.1186/s12957-023-03083-w.

References

Rieder E, Spaun G, Khajanchee Y, Martinec D, Arnold B, Smith Sehdev A . A natural orifice transrectal approach for oncologic resection of the rectosigmoid: an experimental study and comparison with conventional laparoscopy. Surg Endosc. 2011; 25(10):3357-63. DOI: 10.1007/s00464-011-1726-x. View

Leung A, Cheung H, Fok B, Chung C, Li M, Tang C . Prospective randomized trial of hybrid NOTES colectomy versus conventional laparoscopic colectomy for left-sided colonic tumors. World J Surg. 2013; 37(11):2678-82. DOI: 10.1007/s00268-013-2163-x. View

Rautio M, Sipponen A, Lohi J, Lounatmaa K, Koukila-Kahkola P, Laitinen K . In vitro fungistatic effects of natural coniferous resin from Norway spruce (Picea abies). Eur J Clin Microbiol Infect Dis. 2011; 31(8):1783-9. DOI: 10.1007/s10096-011-1502-9. View

Barber M, Walters M, Bump R . Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005; 193(1):103-13. DOI: 10.1016/j.ajog.2004.12.025. View

Matran R . [Nervous control of bronchial circulation in pigs: application to the airway stimulation]. Pathol Biol (Paris). 1991; 39(3):223-9. View

Hida K, Yamaguchi T, Hata H, Kuroyanagi H, Nagayama S, Tada H . Risk factors for complications after laparoscopic surgery in colorectal cancer patients: experience of 401 cases at a single institution. World J Surg. 2009; 33(8):1733-40. DOI: 10.1007/s00268-009-0055-x. View

Guan X, Liu Z, Parvaiz A, Longo A, Saklani A, Shafik A . International consensus on natural orifice specimen extraction surgery (NOSES) for gastric cancer (2019). Gastroenterol Rep (Oxf). 2020; 8(1):5-10. PMC: 7034234. DOI: 10.1093/gastro/goz067. View

Senft J, Warschkow R, Diener M, Tarantino I, Steinemann D, Lamm S . The transvaginal hybrid NOTES versus conventionally assisted laparoscopic sigmoid resection for diverticular disease (TRANSVERSAL) trial: study protocol for a randomized controlled trial. Trials. 2014; 15:454. PMC: 4246541. DOI: 10.1186/1745-6215-15-454. View

Whistance R, Conroy T, Chie W, Costantini A, Sezer O, Koller M . Clinical and psychometric validation of the EORTC QLQ-CR29 questionnaire module to assess health-related quality of life in patients with colorectal cancer. Eur J Cancer. 2009; 45(17):3017-26. DOI: 10.1016/j.ejca.2009.08.014. View

10.

Zhu Z, Wang K, Orangio G, Han J, Lu B, Zhou Z . Clinical efficacy and quality of life after transrectal natural orifice specimen extraction for the treatment of middle and upper rectal cancer. J Gastrointest Oncol. 2020; 11(2):260-268. PMC: 7212109. DOI: 10.21037/jgo.2020.03.05. View

11.

Zhang L, Sun D, Zhang Y, Gao F, Guo Y . Natural orifice specimen extraction surgery in laparoscopic pancreaticoduodenectomy: A single-center case series. Int J Surg. 2020; 82:95-99. DOI: 10.1016/j.ijsu.2020.07.043. View

12.

Demarquay J, Perrin H, Hastier P, Higuero T, Ferrari C, Rampal P . [Large iatrogenic colonic perforation treated by endoscopic suturing]. Gastroenterol Clin Biol. 2010; 34(2):150-3. DOI: 10.1016/j.gcb.2009.09.006. View

13.

Aaronson N, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez N . The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993; 85(5):365-76. DOI: 10.1093/jnci/85.5.365. View

14.

JORGE J, Wexner S . Etiology and management of fecal incontinence. Dis Colon Rectum. 1993; 36(1):77-97. DOI: 10.1007/BF02050307. View

15.

DeSouza A, Domajnko B, Park J, Marecik S, Prasad L, Abcarian H . Incisional hernia, midline versus low transverse incision: what is the ideal incision for specimen extraction and hand-assisted laparoscopy?. Surg Endosc. 2010; 25(4):1031-6. DOI: 10.1007/s00464-010-1309-2. View

16.

Waespe W, Wichmann W . Oculomotor disturbances during visual-vestibular interaction in Wallenberg's lateral medullary syndrome. Brain. 1990; 113 ( Pt 3):821-46. DOI: 10.1093/brain/113.3.821. View

17.

Siegel R, Miller K, Fedewa S, Ahnen D, Meester R, Barzi A . Colorectal cancer statistics, 2017. CA Cancer J Clin. 2017; 67(3):177-193. DOI: 10.3322/caac.21395. View

18.

Dunker M, Stiggelbout A, van Hogezand R, Ringers J, Griffioen G, Bemelman W . Cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn's disease. Surg Endosc. 1998; 12(11):1334-40. DOI: 10.1007/s004649900851. View

19.

Winslow E, Fleshman J, Birnbaum E, Brunt L . Wound complications of laparoscopic vs open colectomy. Surg Endosc. 2002; 16(10):1420-5. DOI: 10.1007/s00464-002-8837-3. View

20.

Singh R, Omiccioli A, Hegge S, McKinley C . Does the extraction-site location in laparoscopic colorectal surgery have an impact on incisional hernia rates?. Surg Endosc. 2008; 22(12):2596-600. DOI: 10.1007/s00464-008-9845-8. View