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Abstract
Objective: To evaluate the feasibility and safety of natural orifice specimen extraction in laparoscopic colorectal surgery.
Material and Method: Retrospective study in 10 patients from 09/2012 to 09/2013, including 8 female and 2 male patients. Average age was 58.3 ± 12.9. Average body weight was 51.5 ± 3.9 kg. Average distance from anal verge to tumor was 11.8 ± 4.0 cm. Stage II presented in 3 cases and stage III in 7 cases.
Results: 50% of patients underwent anterior resection, and 50% underwent low anterior resection. The average tumor diameter was 3.9 ± 1.6 cm. The specimen was retrieved via the transanal approach in 3 patients and via the transvaginal approach in 7 patients. One case was converted to standard specimen retrieval. There was no mortality or intraoperative/postoperative complications. The average operating time was 148 ± 28 minutes. Postoperative pain on the second day was 3.8 ± 1.6 points. The average hospital stay was 7.4 ± 0.8 days. There was no anastomotic fistula, incision infection, or intra-abdominal abscess. The distal and proximal tumor margins were 3.4 cm and 8.1 cm, respectively. With an average follow-up of 6.4 ± 3.2 months, no vaginal recurrence was observed.
Conclusion: Natural orifice specimen extraction (NOSE) in laparoscopic colorectal surgery is feasible and safe, with advantages such as less postoperative pain and lower incision-related infections. NOSE is recommended for patients with tumors under 6 cm for the transanal approach and under 4 cm for the transvaginal approach.
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