A comparison of the efficacy and safety of natural orifice specimen extraction and conventional laparoscopic surgery in patients with sigmoid colon/high rectal cancer.

OBJECTIVE

This study aimed to investigate the efficacy and safety of natural orifice specimen extraction surgery (NOSES) compared to conventional laparoscopic radical resection in the treatment of patients with sigmoid colon/high rectal cancer.

METHODS

The control group (n = 62) underwent traditional laparoscopic radical resection, and the observation group (n = 62) underwent transanal NOSES laparoscopic radical resection. The operation length; amount of bleeding; number of lymph node dissections and days of hospitalization after surgery; visual pain scores on the first and third days after surgery; first leaving bed, anal exhaust, eating a liquid diet, and effective sleep times; and the postoperative complications (abdominal or incision infection or anastomotic fistula) of the two groups of patients were compared and analyzed.

RESULTS

The effective sleep time of the observation group on the first day after the operation was 12.3 ± 2.9 h, which was longer than that of the control group (10.6 ± 3.2 h), and the difference was statistically significant (p < 0.001). The pain degree of the two groups on the third day after the operation was lower than that on the first day, and the pain score of the observation group was lower than that of the control group (2.0 ± 1.0 vs. 3.2 ± 1.2, p < 0.001). The postoperative hospital stay in the observation group was significantly shorter than that in the control group (9.7 ± 2.3 vs. 11.2 ± 2.6, p < 0.001). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (3.2% vs. 12.9%, p = 0.048). In addition, it was found that the first leaving bed, anal exhaust and liquid diet times in the observation group were significantly shorter than those in the control group (p < 0.001).

CONCLUSION

Laparoscopic radical resection NOSES in patients with sigmoid colon cancer or high rectal cancer leads to lower postoperative pain and longer sleep time than in patients who undergo traditional laparoscopic radical surgery. The complication rate of this procedure is low, and the curative effect is safe and positive.