Cargando…

Comparison of short-term and survival outcomes for transanal natural orifice specimen extraction with conventional mini-laparotomy after laparoscopic anterior resection for colorectal cancer

BACKGROUND: Transanal natural orifice specimen extraction (NOSE) in colorectal surgery has been introduced as a less invasive surgery. However, its long-term survival effects remain controversial. The aim of this study was to compare the short-term and long-term survival outcomes of transanal NOSE w...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhou, Sicheng, Wang, Xuewei, Zhao, Chuanduo, Pei, Wei, Zhou, Haitao, Liu, Qian, Liang, Jianwei, Zhou, Zhixiang, Wang, Xishan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611704/
https://www.ncbi.nlm.nih.gov/pubmed/31303795
http://dx.doi.org/10.2147/CMAR.S209194
_version_ 1783432745987342336
author Zhou, Sicheng
Wang, Xuewei
Zhao, Chuanduo
Pei, Wei
Zhou, Haitao
Liu, Qian
Liang, Jianwei
Zhou, Zhixiang
Wang, Xishan
author_facet Zhou, Sicheng
Wang, Xuewei
Zhao, Chuanduo
Pei, Wei
Zhou, Haitao
Liu, Qian
Liang, Jianwei
Zhou, Zhixiang
Wang, Xishan
author_sort Zhou, Sicheng
collection PubMed
description BACKGROUND: Transanal natural orifice specimen extraction (NOSE) in colorectal surgery has been introduced as a less invasive surgery. However, its long-term survival effects remain controversial. The aim of this study was to compare the short-term and long-term survival outcomes of transanal NOSE with those of the conventional laparoscopic approach with mini-laparotomy (LAP) for anastomosis construction and specimen extraction in sigmoid colon cancer or rectal cancer. METHODS: From January 2007 to January 2018, a retrospective study was conducted at the China National Cancer Center. In total, 52 consecutive patients who underwent laparoscopic anterior resection with NOSE were matched with an additional 52 patients who underwent conventional LAP for colorectal cancer. RESULTS: Patients in the NOSE group experienced shorter time to passage of flatus (2.8±0.8 vs 3.2±0.9 days; p=0.042), less pain (4.2±1.4 vs 5.4±1.7; p=0.003) and less analgesia required (7.7% vs 25.0%; p=0.032). After a median follow-up of 68.5 (range, 8–83) months, the two groups had similar 5-year overall survival rates (92.3% vs 94.2%; p=0.985) and disease-free survival rates (84.6% vs 86.5%; p=0.802). CONCLUSION: Transanal NOSE for total laparoscopic anterior resection is safe and feasible with more advantages, including lower pain, lower tissue trauma and faster recovery of intestinal function. Moreover, with proper protection of the surgical route, transanal NOSE has the same long-term outcomes as conventional laparoscopic surgery.
format Online
Article
Text
id pubmed-6611704
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-66117042019-07-12 Comparison of short-term and survival outcomes for transanal natural orifice specimen extraction with conventional mini-laparotomy after laparoscopic anterior resection for colorectal cancer Zhou, Sicheng Wang, Xuewei Zhao, Chuanduo Pei, Wei Zhou, Haitao Liu, Qian Liang, Jianwei Zhou, Zhixiang Wang, Xishan Cancer Manag Res Original Research BACKGROUND: Transanal natural orifice specimen extraction (NOSE) in colorectal surgery has been introduced as a less invasive surgery. However, its long-term survival effects remain controversial. The aim of this study was to compare the short-term and long-term survival outcomes of transanal NOSE with those of the conventional laparoscopic approach with mini-laparotomy (LAP) for anastomosis construction and specimen extraction in sigmoid colon cancer or rectal cancer. METHODS: From January 2007 to January 2018, a retrospective study was conducted at the China National Cancer Center. In total, 52 consecutive patients who underwent laparoscopic anterior resection with NOSE were matched with an additional 52 patients who underwent conventional LAP for colorectal cancer. RESULTS: Patients in the NOSE group experienced shorter time to passage of flatus (2.8±0.8 vs 3.2±0.9 days; p=0.042), less pain (4.2±1.4 vs 5.4±1.7; p=0.003) and less analgesia required (7.7% vs 25.0%; p=0.032). After a median follow-up of 68.5 (range, 8–83) months, the two groups had similar 5-year overall survival rates (92.3% vs 94.2%; p=0.985) and disease-free survival rates (84.6% vs 86.5%; p=0.802). CONCLUSION: Transanal NOSE for total laparoscopic anterior resection is safe and feasible with more advantages, including lower pain, lower tissue trauma and faster recovery of intestinal function. Moreover, with proper protection of the surgical route, transanal NOSE has the same long-term outcomes as conventional laparoscopic surgery. Dove 2019-07-01 /pmc/articles/PMC6611704/ /pubmed/31303795 http://dx.doi.org/10.2147/CMAR.S209194 Text en © 2019 Zhou et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Zhou, Sicheng
Wang, Xuewei
Zhao, Chuanduo
Pei, Wei
Zhou, Haitao
Liu, Qian
Liang, Jianwei
Zhou, Zhixiang
Wang, Xishan
Comparison of short-term and survival outcomes for transanal natural orifice specimen extraction with conventional mini-laparotomy after laparoscopic anterior resection for colorectal cancer
title Comparison of short-term and survival outcomes for transanal natural orifice specimen extraction with conventional mini-laparotomy after laparoscopic anterior resection for colorectal cancer
title_full Comparison of short-term and survival outcomes for transanal natural orifice specimen extraction with conventional mini-laparotomy after laparoscopic anterior resection for colorectal cancer
title_fullStr Comparison of short-term and survival outcomes for transanal natural orifice specimen extraction with conventional mini-laparotomy after laparoscopic anterior resection for colorectal cancer
title_full_unstemmed Comparison of short-term and survival outcomes for transanal natural orifice specimen extraction with conventional mini-laparotomy after laparoscopic anterior resection for colorectal cancer
title_short Comparison of short-term and survival outcomes for transanal natural orifice specimen extraction with conventional mini-laparotomy after laparoscopic anterior resection for colorectal cancer
title_sort comparison of short-term and survival outcomes for transanal natural orifice specimen extraction with conventional mini-laparotomy after laparoscopic anterior resection for colorectal cancer
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611704/
https://www.ncbi.nlm.nih.gov/pubmed/31303795
http://dx.doi.org/10.2147/CMAR.S209194
work_keys_str_mv AT zhousicheng comparisonofshorttermandsurvivaloutcomesfortransanalnaturalorificespecimenextractionwithconventionalminilaparotomyafterlaparoscopicanteriorresectionforcolorectalcancer
AT wangxuewei comparisonofshorttermandsurvivaloutcomesfortransanalnaturalorificespecimenextractionwithconventionalminilaparotomyafterlaparoscopicanteriorresectionforcolorectalcancer
AT zhaochuanduo comparisonofshorttermandsurvivaloutcomesfortransanalnaturalorificespecimenextractionwithconventionalminilaparotomyafterlaparoscopicanteriorresectionforcolorectalcancer
AT peiwei comparisonofshorttermandsurvivaloutcomesfortransanalnaturalorificespecimenextractionwithconventionalminilaparotomyafterlaparoscopicanteriorresectionforcolorectalcancer
AT zhouhaitao comparisonofshorttermandsurvivaloutcomesfortransanalnaturalorificespecimenextractionwithconventionalminilaparotomyafterlaparoscopicanteriorresectionforcolorectalcancer
AT liuqian comparisonofshorttermandsurvivaloutcomesfortransanalnaturalorificespecimenextractionwithconventionalminilaparotomyafterlaparoscopicanteriorresectionforcolorectalcancer
AT liangjianwei comparisonofshorttermandsurvivaloutcomesfortransanalnaturalorificespecimenextractionwithconventionalminilaparotomyafterlaparoscopicanteriorresectionforcolorectalcancer
AT zhouzhixiang comparisonofshorttermandsurvivaloutcomesfortransanalnaturalorificespecimenextractionwithconventionalminilaparotomyafterlaparoscopicanteriorresectionforcolorectalcancer
AT wangxishan comparisonofshorttermandsurvivaloutcomesfortransanalnaturalorificespecimenextractionwithconventionalminilaparotomyafterlaparoscopicanteriorresectionforcolorectalcancer