Totally laparoscopic resection with natural orifice specimen extraction for carcinoma of sigmoid colon and rectum: a feasible and innovative technique.
OBJECTIVE
To testify the feasibility and safety of an innovative technique we performed.


BACKGROUND
An abdominal incision is required to extract a specimen for laparoscopic-assisted colorectal operation, and the incision brings some disadvantages for surgeons and patients. Natural orifice specimen extraction (NOSE) is developed to avoid these disadvantages.


METHODS
Between May 2012 and March 2013, we attempted to perform totally laparoscopic resection with NOSE in 27 patients with sigmoid colon cancer or rectal cancer. Procedure of this technique was described and clinic data of all 27 patients were collected and analyzed.


RESULTS
We successfully completed the technique of NOSE in 24 of these patients. Mean operation time was 110.0 minutes and mean intraoperative blood loss was 69.1 mL in 23 patients (not including one patient who received additional bilateral oophorectomy) who underwent NOSE. Of these 24 patients, the mean time to passing of first flatus was 3.1 days, the mean postoperative hospital stay was 9.2 days, and 2 patients used analgesics after operation; 22 patients were able to walk in first 2 days, 2 patients had postoperative complications.


CONCLUSIONS
Totally laparoscopic resection with NOSE is suited for selected patients with sigmoid colon cancer or rectal cancer, and this technique is worth to recommend and spread.
*Department of Gastrointestinal Surgery †The Overall Planning Office, Cancer Hospital ‡State Key Laboratory of Molecular Oncology, Cancer Institute and Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Xingmao
X
Zhang
Haitao
H
Zhou
Huirong
H
Hou
Junjie
J
Hu
Hongying
H
Wang
Zhixiang
Z
Zhou
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D016063:Blood Loss, Surgical; D004434:Early Ambulation; D005240:Feasibility Studies; D005260:Female; D005414:Flatulence / Q000503:physiopathology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D010149:Postoperative Pain / Q000188:drug therapy; D020127:Recovery of Function; D012004:Rectal Neoplasms / Q000601:surgery*; D012811:Sigmoid Neoplasms / Q000601:surgery*; D013048:Specimen Handling / Q000379:methods
D000700:Analgesics