Outcomes after natural orifice extraction vs conventional specimen extraction surgery for colorectal cancer: A propensity scorematched analysis  

作　　者：Isaac Seow-En Lionel Raphael Chen Yi-Xin Li Yun Zhao Jing-Hui Chen Hairil Rizal Abdullah Emile Kwong-Wei Tan 

机构地区：[1]Department of Colorectal Surgery,Singapore General Hospital,Singapore 169608,Singapore [2]Department of Surgery,Duke-NUS Graduate Medical School,Singapore 169857,Singapore [3]Department of Anaesthesiology,Singapore General Hospital,Singapore 169608,Singapore

出　　处：《World Journal of Clinical Oncology》2022年第10期789-801,共13页世界临床肿瘤学杂志（英文版）

摘　　要：BACKGROUND 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 incisionrelated morbidity.AIM To compare short-term outcomes following 3-port NOSE surgery with a matched cohort of conventional non-NOSE colorectal cancer surgery.METHODS Patients who underwent elective 3-port laparoscopic colorectal NOSE surgery between February to October 2021 were identified.Selection criteria for NOSE surgery was adapted from the 2019 International Consensus on Natural Orifice Specimen Extraction Surgery for colorectal cancer.Patients with clinical T4 or N2 tumors on staging computed tomography were also excluded.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.RESULTS Over the eight-month study duration,14 consecutive cases(nine female,five male)of elective 3-port laparoscopic surgery with NOSE were performed for colorectal cancer.Median age and body mass index were 70(range 43-82)years and 24.1(range 20.0-31.7)kg/m2 respectively.Six patients underwent transanal NOSE and eight had transvaginal NOSE.Median operative time,intraoperative blood loss and postoperative length of stay were 208(range 165-365)min,30(range 10-150)mL and 3(range 2-6)d respectively.Two(14%)suffered minor postoperative compilations not attributable to the NOSE procedure.Median follow-up duration was 12(range 8-15)mo.No instances of mortality,local or distant disease recurrence were recorded in this cohort.Compared to the conventional surgery cohort of 56 patients,the 3-port NOSE cohort had significantly quicker mean

关 键 词：3-port laparoscopy Colorectal surgery Natural orifice specimen extraction TRANSANAL TRANSVAGINAL Minimally invasive surgery 

分 类 号：R735.34[医药卫生—肿瘤]