Modified natural orifice specimen extraction type IV surgery for rectosigmoid cancer: A retrospective clinical study

Table 1 General patient information, n (%)

Item		Modified NOSES (n = 19)	Standard NOSES (n = 21)	χ2/t/Z	P value
Gender	Female	12 (63.16)	12 (57.14)	0.15	0.755
	Male	7 (36.84)	9 (42.86)
Tumor staging	I	12 (63.16)	7 (33.33)	-1.435	0.151
	II	3 (15.79)	9 (42.86)
	III	4 (21.05)	5 (23.81)
Tumor size (cm), mean ± SD		2.26 ± 0.91	2.85 ± 1.06	1.878	0.068
Years, mean ± SD		56.6 ± 13.55	55.19 ± 12.91	0.344	0.732
Distance of tumor from anus (cm)		20.89 ± 7.34	17.95 ± 2.27	-1.673	0.109
BMI (kg/m2), mean ± SD		22.75 ± 3.09	21.85 ± 2.54	-1.014	0.317

BMI: Body mass index; NOSES: Natural orifice specimen extraction surgery.

Table 2 Comparison of perioperative parameters between groups, mean ± SD

Item	Modified NOSES (n = 19)	Standard NOSES (n = 21)	t	P value
Intraoperative blood loss (mL)	8.79 ± 10.99	26.9 ± 29.35	2.632	0.014a
Number of lymph nodes harvested	13.89 ± 7.49	17.48 ± 5.72	1.709	0.096
Operative time (minute)	174.37 ± 41.88	216.43 ± 69.35	2.291	0.028a
24-hour postoperative pain score (VAS)	1.11 ± 0.81	1.38 ± 1.12	0.885	0.381
Postoperative body temperature (°C)	36.76 ± 0.39	36.74 ± 0.31	-0.182	0.856

^aP < 0.05.

VAS: Visual Analog Scale; NOSES: Natural orifice specimen extraction surgery.

Table 3 Comparison of perioperative parameters between groups, n (%)

Item		Modified NOSES (n = 19)	Standard NOSES (n = 21)	χ2/t/Z	P value
Postoperative CRP (mg/L), mean ± SD		49.33 ± 31.08	50.11 ± 33.35	0.076	0.94
Intra-abdominal infection		2 (10.53)	2 (9.52)	0.011	0.658
Urinary retention		2 (10.53)	4 (19.05)	0.568	0.664
Bowel obstruction		1 (5.26)	1 (5.26)	0.731	1
Total surgical cost (¥), mean ± SD		32554.1 ± 12022.29	51975.26 ± 10570.89	5.437	< 0.001a
Anastomotic leakage	Grade A	1 (5.26)	1 (5.26)	-0.534	0.593
	Grade B	0 (0.00)	1 (5.26)
	Grade C	0 (0.00)	0 (0.00)

^aP < 0.001.

CRP: C-reactive protein; NOSES: Natural orifice specimen extraction surgery.

Table 4 Comparison of postoperative recovery between groups, mean ± SD

Item	Modified NOSES (n = 19)	Standard NOSES (n = 21)	t	P value
First oral intake (days)	5.05 ± 2.20	4.48 ± 1.37	-1.007	0.32
First flatus (days)	3.43 ± 1.36	2.84 ± 1.07	1.504	0.141
First defecation (days)	3.37 ± 0.96	4.43 ± 1.96	2.202	0.036a
Ambulation (days)	4.43 ± 1.96	2.84 ± 1.07	-0.286	0.174
Hospital stay (days)	9.58 ± 2.22	9.33 ± 3.09	-1.4	0.71
Drainage removal (days)	6.21 ± 3.07	5.90 ± 2.05	-0.374	0.32

^aP < 0.05.

NOSES: Natural orifice specimen extraction surgery.

Table 5 Multivariable linear regression analysis results of factors associated with operative cost

Variables	Unstandardized β (95%CI)	Standardized β	P value
Gender	-3452 (-10756 to 3852)	-0.115	0.341
Age (years)	-129 (-401 to 143)	-0.113	0.334
BMI (kg/m²)	236 (-1153 to 1626)	0.045	0.729
Distance from the anus (cm)	713 (88-1338)	0.262	0.025a
Modified surgical approach	-21307 (-28742 to -13872)	-0.726	< 0.001b
Intraoperative blood loss (mL)	-125 (-276 to 25)	-0.204	0.099
Tumor size (cm)	3912 (520-7304)	0.270	0.024a

^aP < 0.05.

^bP < 0.001.

Model summary: r = 0.804, R² = 0.647, adjusted R² = 0.569, Durbin-Watson = 1.302. BMI: Body mass index; CI: Confidence interval.

Table 6 Multivariable linear regression analysis results of factors associated with operative time

Variables	Unstandardized β (95%CI)	Standardized β	P value
Gender	5.0 (-35.3 to 45.4)	0.041	0.803
Age (years)	0.4 (-1.1 to 1.9)	0.088	0.582
BMI (kg/m²)	1.6 (-6.0 to 9.3)	0.076	0.670
Distance from the anus (cm)	2.5 (-1.0 to 5.9)	0.222	0.156
Modified surgical approach	-49.9 (-90.8 to -9.0)	-0.415	0.019a
Intraoperative blood loss (mL)	-0.6 (-1.5 to 0.2)	-0.256	0.129
Tumor size (cm)	17.5 (-1.1 to 36.2)	0.295	0.067

^aP < 0.05.

Model summary: r = 0.582, R² = 0.339, adjusted R² = 0.194, Durbin-Watson = 1.568. BMI: Body mass index; CI: Confidence interval.