Published online Oct 24, 2022. doi: 10.5306/wjco.v13.i10.789
Peer-review started: August 30, 2022
First decision: September 26, 2022
Revised: October 8, 2022
Accepted: October 12, 2022
Article in press: October 12, 2022
Published online: October 24, 2022
Processing time: 50 Days and 21.7 Hours
Natural orifice specimen extraction (NOSE) via the anus or vagina replaces conventional transabdominal specimen retrieval via the transabdominal route through a limited mid-line laparotomy or Pfannenstiel incision. Reducing the number of laparoscopic ports further decreases operative abdominal wall trauma. These techniques reduce the surgical wound size as well as the risk of incision-related morbidity.
To our knowledge, the technique of 3-port colorectal cancer surgery with NOSE has never been evaluated or described in-depth.
To compare short-term outcomes following 3-port NOSE surgery with a matched cohort of conventional non-NOSE colorectal cancer surgery.
This was a retrospective cohort study of patients who underwent elective 3-port laparoscopic colorectal NOSE surgery between February to October 2021. The propensity score-matched cohort was identified amongst patients who underwent conventional laparoscopic colorectal surgery from January 2019 to December 2020. Matching was performed in the ratio of 1:4 based on age, gender, type of resection, and p - tumor node metastasis staging.
Our results showede no statistical differences in surgical duration and perioperative complication rates between the NOSE and non-NOSE cohorts. As hypothesized, the 3-port NOSE cohort had significantly quicker mean return of bowel function (2.6 vs 1.2 d, P < 0.001), reduced postoperative pain and patient-controlled analgesia use, and decreased length of hospital stay (6.4 vs 3.4 d, P < 0.001), compared to the conventional surgery cohort.
3-port laparoscopic colorectal surgery with NOSE is a feasible technique, augmenting the minimally invasive nature of surgery and producing good outcomes.
Studies with larger patient numbers are necessary to draw definitive conclusions. A defined criteria should be evaluated for more objective selection of patients who are considered for colorectal NOSE surgery.