SynthesisSurgical endoscopy2025
Laparoscopic natural orifice specimen extraction for diverticular disease: a systematic review.
Synthesis in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Laparoscopic Resection Rectopexy with Transanal Specimen Extraction for Complete Rectal Prolapse: Retrospective Cohort Study of Functional Outcomes.Journal of clinical medicine · 2026Article
- Review
- Natural orifice specimen extraction for diverticular disease: technique, outcomes and role of inflammatory markers.Surgical endoscopy · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiverticular disease is extremely common in the Western world, with a proportion of complications requiring colonic resection. Whilst laparoscopic surgery has its benefits, a large wound for specimen extraction predisposes to surgical site infection, prolonged pain and prolonged hospital admission. Natural orifice specimen extraction (NOSE) is an alternative technique that has not yet been widely adopted in diverticular disease surgery. The aim of this systematic review is to evaluate the evidence on the outcomes of NOSE in left sided resections for diverticular disease.
methodsA systematic review of PubMed, Ovid MEDLINE and EMBASE was performed to identify studies that reported outcomes for left sided resections with NOSE in diverticular disease. The studies reviewed were all human studies published in a peer-reviewed journal after 2010. The participants had to be over the age of 18 and the extraction site had to be transanal/transrectal. Articles that were not full text or not in English were excluded. These studies were assessed independently by two reviewers using a standardised pre-piloted form.
resultsOne hundred and eighty-seven articles were screened, with 9 articles meeting the inclusion criteria. The study sample size ranged from 8 to 157 participants, with a pooled total of 428 patients who had NOSE. Hospital length of stay varied from 4 to 6 days. Only 2 patients required conversion to transabdominal extraction. Pain scores were lower post-NOSE compared to traditional abdominal extraction in 2 out of 3 studies. The anastomotic leak rate varied from 0 to 18%. Six studies reported no surgical site infections and there was only 1 mortality.
conclusionNOSE is a safe and feasible option for patients requiring left sided resection for diverticular disease based on the current available data. The literature demonstrates low rates of surgical site infection, mortality and reduced hospital length of stay.
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