ArticleSurgical endoscopy2022
Natural orifice versus conventional mini-laparotomy for specimen extraction after reduced-port laparoscopic surgery for colorectal cancer: propensity score-matched comparative study.
Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- A randomized controlled trial comparing robotic NOSES versus robotic TME for Mid-rectal cancer: short-term oncological and perioperative outcomes.Journal of robotic surgery · 2026Trial
- Laparoscopic-assisted natural orifice specimen extraction subtotal colectomy for redundant colon: a retrospective parallel-cohort comparative study with reduced surgical site infections and accelerated recovery.Frontiers in surgery · 2026Article
- Three-step dissection with straight needle suturing for anvil placement in Natural Orifice Specimen Extraction Surgery (NOSES).Journal of surgical case reports · 2025Article
- Review
- Robotic surgery for rectal cancer resection with complete intracorporeal double-stapling technique.Techniques in coloproctology · 2024Article
- Short-term clinical effects and inflammatory response of natural orifice specimen extraction surgery versus conventional laparoscopic-assisted surgery for the treatment of sigmoid and rectal cancer.Journal of gastrointestinal oncology · 2023Article
- Peritoneal contamination and associated post-operative infectious complications after natural orifice specimen extraction for laparoscopic colorectal surgery.Surgical endoscopy · 2022Article
- Technical feasibility and perioperative outcome of laparoscopic resection rectopexy with natural orifice specimen extraction (NOSE) and intracorporeal anastomosis (ICA).Langenbeck's archives of surgery · 2022Article
- Single-operator-conducted natural orifice specimen extraction surgery (NOSES) for sigmoid colon cancer.Gastroenterology report · 2022Article
- Influence of transvaginal laparoscopic surgery on sexual function, life quality and short-term efficacy of patients diagnosed with colorectal cancer.American journal of translational research · 2022Article
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Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough reduced port laparoscopic surgery (RPLS), defined as laparoscopic surgery performed with the minimum possible number of ports and/or small-sized ports, is less invasive than conventional laparoscopic surgery by reducing the number of surgical wounds, an extension of the incision is still needed for specimen extraction, which can undermine the merits of RPLS.
objectiveTo determine the impact of natural orifice specimen extraction (NOSE) in patients undergoing RPLS for colorectal cancer. The endpoints were perioperative outcome and oncologic safety at 3 years.
settingSingle-center experience (2013-2019). PATIENTS: We retrospectively analyzed our prospectively collected patient records (American Joint Committee on Cancer (AJCC) stage I-III sigmoid or upper rectal cancer (tumor diameter ≤ 5 cm) who underwent curative anterior resection via RPLS. We excluded patients who did not undergo intestinal anastomosis.
interventionsPerioperative and oncologic outcomes were compared between patients undergoing natural orifice (RPLS-NOSE) or conventional (mini-laparotomy) specimen extraction (RPLS-CSE). Patients were matched by propensity scores 1:1 for tumor diameter, AJCC stage, American Society of Anesthesiologists score and tumor location.
resultsOf 119 eligible patients, 104 were matched (52 RPLS-NOSE; 52 RPLS-CSE) by propensity scores. Compared with RPLS-CSE, RPLS-NOSE was associated with longer operative time (223.9 vs. 188.7 min; p = 0.003), decreased use of analgesics (morphine dose 33.9 vs. 43.4 mg; p = 0.011) and duration of hospital stay (4.2 vs. 5.1 days; p = 0.001). No statistically significant difference was found in morbidity or wound-related complication rates between the two groups. After a median follow-up of 34.3 months, no local recurrence was observed in RPLS-NOSE. The 3-year disease-free survival did not differ statistically significantly between groups (90.9 vs. 90.5%; p = 0.610).
conclusionNOSE enhances the advantages of RPLS by avoiding the need for abdominal wall specimen extraction in patients with tumor diameter ≤ 5 cm. Surgical and oncologic safety are comparable to RPLS with CSE.
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