Three-Port with Natural Orifice Specimen Extraction versus Conventional Laparoscopic Anterior Resection for Rectal-Sigmoid Cancer: A Matched Pair Analysis
Background The conventional laparoscopic colorectal surgery requires four or more ports to accomplish the laparoscopic dissection, and a mini-laparotomy to remove the specimen, which is a main cause of postoperative pain and incision complications, and compromise the cosmetic results. Reduced port s...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2022-04-01
|
| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2021.1956651 |
| _version_ | 1797684461818609664 |
|---|---|
| author | Haiyang Zhou Anqi Wang Hao Lu Jia Wu Jun Ying Zhiqian Hu Canping Ruan |
| author_facet | Haiyang Zhou Anqi Wang Hao Lu Jia Wu Jun Ying Zhiqian Hu Canping Ruan |
| author_sort | Haiyang Zhou |
| collection | DOAJ |
| description | Background The conventional laparoscopic colorectal surgery requires four or more ports to accomplish the laparoscopic dissection, and a mini-laparotomy to remove the specimen, which is a main cause of postoperative pain and incision complications, and compromise the cosmetic results. Reduced port surgery and natural orifice specimen extraction (NOSE) surgery hold the promise to overcome these drawbacks. This study planned to compare peri-operative outcomes of patients with rectal-sigmoid cancer undergoing three-port laparoscopic anterior resection with NOSE (three-port NOSE LAR) to those of patients receiving conventional LAR. Methods Twenty-five patients with rectal-sigmoid cancer underwent three-port NOSE LAR between December 2018 and October 2020. For comparison, 50 patients with rectal-sigmoid cancer underwent conventional LAR in the same period were matched. The peri-operative outcomes were compared. Results Operating time of three-port NOSE group was slightly longer than that of conventional group (135 min vs. 121 min, p = .147). The incision length of three-port NOSE group was shorter than that of conventional group (2.9 cm vs. 7.4 cm, p = .000). Complication rates in three-port NOSE group and conventional group were similar (12.0% vs. 20.0%, p = .524). The tumor size was smaller in three-port NOSE group than the conventional group (2.1 cm vs. 3.5 cm, p = .000). Pain score was lower in three-port NOSE group than the conventional group at postoperative day 1 (1.6 vs. 3.0, p = 0.045) and day 2 (0.2 vs. 2.1, p = .003). The BIQ score was significantly higher in the three-port NOSE group compared to the conventional group (42.9 ± 3.5 vs. 38.2 ± 2.5, p = .002). Conclusions Three-port NOSE LAR for rectal-sigmoid cancer is feasible and provides similar peri-operative outcomes compared to conventional LAR. It reduces postoperative pain and produces better cosmesis. |
| first_indexed | 2024-03-12T00:29:59Z |
| format | Article |
| id | doaj.art-46b7f7fd79a445aaaadb9dc0d33698a8 |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:29:59Z |
| publishDate | 2022-04-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-46b7f7fd79a445aaaadb9dc0d33698a82023-09-15T10:21:28ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532022-04-0135478879210.1080/08941939.2021.19566511956651Three-Port with Natural Orifice Specimen Extraction versus Conventional Laparoscopic Anterior Resection for Rectal-Sigmoid Cancer: A Matched Pair AnalysisHaiyang Zhou0Anqi Wang1Hao Lu2Jia Wu3Jun Ying4Zhiqian Hu5Canping Ruan6Division of Colorectal Surgery, Changzheng HospitalDivision of Colorectal Surgery, Changzheng HospitalDivision of Colorectal Surgery, Changzheng HospitalDivision of General Practice Medicine, Changzheng HospitalDivision of Colorectal Surgery, Changzheng HospitalDivision of Colorectal Surgery, Changzheng HospitalDivision of Colorectal Surgery, Changzheng HospitalBackground The conventional laparoscopic colorectal surgery requires four or more ports to accomplish the laparoscopic dissection, and a mini-laparotomy to remove the specimen, which is a main cause of postoperative pain and incision complications, and compromise the cosmetic results. Reduced port surgery and natural orifice specimen extraction (NOSE) surgery hold the promise to overcome these drawbacks. This study planned to compare peri-operative outcomes of patients with rectal-sigmoid cancer undergoing three-port laparoscopic anterior resection with NOSE (three-port NOSE LAR) to those of patients receiving conventional LAR. Methods Twenty-five patients with rectal-sigmoid cancer underwent three-port NOSE LAR between December 2018 and October 2020. For comparison, 50 patients with rectal-sigmoid cancer underwent conventional LAR in the same period were matched. The peri-operative outcomes were compared. Results Operating time of three-port NOSE group was slightly longer than that of conventional group (135 min vs. 121 min, p = .147). The incision length of three-port NOSE group was shorter than that of conventional group (2.9 cm vs. 7.4 cm, p = .000). Complication rates in three-port NOSE group and conventional group were similar (12.0% vs. 20.0%, p = .524). The tumor size was smaller in three-port NOSE group than the conventional group (2.1 cm vs. 3.5 cm, p = .000). Pain score was lower in three-port NOSE group than the conventional group at postoperative day 1 (1.6 vs. 3.0, p = 0.045) and day 2 (0.2 vs. 2.1, p = .003). The BIQ score was significantly higher in the three-port NOSE group compared to the conventional group (42.9 ± 3.5 vs. 38.2 ± 2.5, p = .002). Conclusions Three-port NOSE LAR for rectal-sigmoid cancer is feasible and provides similar peri-operative outcomes compared to conventional LAR. It reduces postoperative pain and produces better cosmesis.http://dx.doi.org/10.1080/08941939.2021.1956651rectal-sigmoid cancernatural orifice specimen extractionthree-portlaparoscopic surgeryanterior resection |
| spellingShingle | Haiyang Zhou Anqi Wang Hao Lu Jia Wu Jun Ying Zhiqian Hu Canping Ruan Three-Port with Natural Orifice Specimen Extraction versus Conventional Laparoscopic Anterior Resection for Rectal-Sigmoid Cancer: A Matched Pair Analysis Journal of Investigative Surgery rectal-sigmoid cancer natural orifice specimen extraction three-port laparoscopic surgery anterior resection |
| title | Three-Port with Natural Orifice Specimen Extraction versus Conventional Laparoscopic Anterior Resection for Rectal-Sigmoid Cancer: A Matched Pair Analysis |
| title_full | Three-Port with Natural Orifice Specimen Extraction versus Conventional Laparoscopic Anterior Resection for Rectal-Sigmoid Cancer: A Matched Pair Analysis |
| title_fullStr | Three-Port with Natural Orifice Specimen Extraction versus Conventional Laparoscopic Anterior Resection for Rectal-Sigmoid Cancer: A Matched Pair Analysis |
| title_full_unstemmed | Three-Port with Natural Orifice Specimen Extraction versus Conventional Laparoscopic Anterior Resection for Rectal-Sigmoid Cancer: A Matched Pair Analysis |
| title_short | Three-Port with Natural Orifice Specimen Extraction versus Conventional Laparoscopic Anterior Resection for Rectal-Sigmoid Cancer: A Matched Pair Analysis |
| title_sort | three port with natural orifice specimen extraction versus conventional laparoscopic anterior resection for rectal sigmoid cancer a matched pair analysis |
| topic | rectal-sigmoid cancer natural orifice specimen extraction three-port laparoscopic surgery anterior resection |
| url | http://dx.doi.org/10.1080/08941939.2021.1956651 |
| work_keys_str_mv | AT haiyangzhou threeportwithnaturalorificespecimenextractionversusconventionallaparoscopicanteriorresectionforrectalsigmoidcanceramatchedpairanalysis AT anqiwang threeportwithnaturalorificespecimenextractionversusconventionallaparoscopicanteriorresectionforrectalsigmoidcanceramatchedpairanalysis AT haolu threeportwithnaturalorificespecimenextractionversusconventionallaparoscopicanteriorresectionforrectalsigmoidcanceramatchedpairanalysis AT jiawu threeportwithnaturalorificespecimenextractionversusconventionallaparoscopicanteriorresectionforrectalsigmoidcanceramatchedpairanalysis AT junying threeportwithnaturalorificespecimenextractionversusconventionallaparoscopicanteriorresectionforrectalsigmoidcanceramatchedpairanalysis AT zhiqianhu threeportwithnaturalorificespecimenextractionversusconventionallaparoscopicanteriorresectionforrectalsigmoidcanceramatchedpairanalysis AT canpingruan threeportwithnaturalorificespecimenextractionversusconventionallaparoscopicanteriorresectionforrectalsigmoidcanceramatchedpairanalysis |