Short-term efficacy of natural orifice specimen extraction surgery for low rectal cancer
Short-term efficacy of natural orifice specimen extraction surgery for low rectal cancer作者机构：Department of Anorectal Surgery Huaihe Hospital Affiliated to Henan University Evidence-Based Medicine Center Huaihe Hospital Affiliated to Henan University Department of Clinical Laboratory Translational Medicine Center Huaihe Hospital Affiliated to Henan University
出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)
年 卷 期：2019年第7卷第2期
页 面：122-129页
核心收录：
基 金：Supported by National Natural Science Foundation of China,No.81500430 and No.U1304802(to Lin XH) Basic and Frontier Technology Research Program of Henan Province,No.162300410101(to Hu JH) Wu Jieping Medical Foundation of Clinical Research Special Fund,No.320.2710.1836(to Hu JH) The Henan Science and Technology Planning Project,No.182102310544(to Lin XH)
主 题：Natural orifice specimen extraction surgery Low rectal cancer Laparoscopy Prolapsing technique No auxiliary incision
摘 要：BACKGROUND This case-control study compared the short-term clinical efficacy of natural orifice specimen extraction surgery(NOSES) using a prolapsing technique and the conventional laparoscopic-assisted approach for low rectal cancer.AIM To further explore the application value of the transanal placement of the anvil and to evaluate the short-term efficacy of NOSES for resecting specimens of low rectal cancer, as well as to provide a theoretical basis for its extensive clinical application.METHODS From June 2015 to June 2018, 108 consecutive laparoscopic-assisted low rectal cancer resections were performed at our center. Among them, 26 specimens were resected transanally using a prolapsing technique(NOSES), and 82 specimens were resected through a conventional abdominal wall small incision(LAP). A propensity score matching method was used to select 26 pairs of matched patients, and their perioperative data were analyzed.RESULTS The baseline data were comparable between the two matched groups. All 52 patients underwent the surgery successfully. The operative time, blood loss,number of harvested lymph nodes, postoperative complication rate,circumferential margin involvement, postoperative follow-up data, and postoperative anal function were not statistically significant. The NOSES group had shorter time to gastrointestinal function recovery(2.6 ± 1.0 d vs 3.4 ± 0.9 d, P= 0.006), shorter postoperative hospital stay(7.1 ± 1.7 d vs 8.3 ± 1.1 d, P = 0.003),lower pain score(day 1: 2.7 ± 1.8 vs 4.6 ± 1.9, day 3: 2.0 ± 1.1 vs 4.1 ± 1.2, day 5: 1.7± 0.9 vs 3.3 ± 1.0, P 0.001), a lower rate of additional analgesic use(11.5% vs61.5%, P = 0.001), and a higher satisfaction rate in terms of the aesthetic appearance of the abdominal wall after surgery(100% vs 23.1%, P 0.001).CONCLUSION NOSES for low rectal cancer can achieve satisfactory short-term efficacy and has advantages in reducing postoperative pain, shortening the length of postoperative hospital stay, and improving patients satisfaction in terms of a more aesthetic appearance of the abdominal wall.
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