Abstract:
Objective To investigate and compare the effect of laparoscopic natural orifice specimen extraction surgery (NOSES) using a prolapsing technique with that of traditional laparoscopic anterior rectectomy (LAR) for middle and low rectal cancer.
Methods The clinical data of 60 rectal cancer patients admitted to Heze Municipal Hospital from January 2019 to January 2020 were retrospectively analyzed and compared. The patients were assigned equally into an observation group (treated with laparoscopic NOSES, n=30), and a control group (treated with traditional LAR, n=30). The patients were observed during a follow-up period of 6-12 months for tumor recurrence.
Results All operations were successfully completed without conversion to laparotomy. There were no significant differences between the two groups in terms of intraoperative blood loss, number of harvested, lymphnodes, postoperative complications, and tumor recurrence rate (P>0.05). The observation group was significantly better than the control group in terms of operation time, pain index, time to ambulation, anal exhaust time, time to the first feeding and duration of hospital stay (P<0.05).
Conclusions Complete laparoscopic NOSES for middle and low rectal cancer is feasible. Compared with traditional LAR, laparoscopic NOSES was associated with a shorter operation time, less pain, early ambulation, early anal exhaust, early feeding, shorter hospital stay, lack of auxiliary incision scar in the abdomen, and rapid rehabilitation. Postoperative complications and tumor recurrence rates did not increase significantly with this technique. Therefore the technique may be performed for eligible patients.
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