Laparoscopic surgery for rectal cancer, specimen extraction: transanal or transabdominal?
Abstract Background Comparison of natural orifice specimen extraction (NOSE) and transabdominal specimen extraction (TASE) in colorectal surgery remains controversial. Herein, we aimed to perform a retrospective analysis on surgical outcomes of NOSE and TASE at three hospitals in east of Iran. Metho...
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BMC
2023-06-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-023-02059-7 |
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| author | Fatemeh Shahabi Ala Orafaie Majid Ansari Zahra Gholami Moallem Ali Mehri Maryam Hejri Moghadam Reza Roshanravan Abbas Abdollahi Mahboobeh Rasouli |
| author_facet | Fatemeh Shahabi Ala Orafaie Majid Ansari Zahra Gholami Moallem Ali Mehri Maryam Hejri Moghadam Reza Roshanravan Abbas Abdollahi Mahboobeh Rasouli |
| author_sort | Fatemeh Shahabi |
| collection | DOAJ |
| description | Abstract Background Comparison of natural orifice specimen extraction (NOSE) and transabdominal specimen extraction (TASE) in colorectal surgery remains controversial. Herein, we aimed to perform a retrospective analysis on surgical outcomes of NOSE and TASE at three hospitals in east of Iran. Method Consecutive locally advanced rectal adenocarcinoma patients who underwent laparoscopic surgery using either NOSE or TASE from 2011 to 2017 were recruited. These patients were followed-up till 2020. Data, including postoperative complications, long-term overall and recurrence-free survival were analyzed retrospectively. Results 239 eligible patients were included in this study. 169 (70.71%) patients underwent NOSE, and 70 (29.29%) patients underwent TASE. Although this study has achieved similar outcomes in terms of overall and recurrence-free survival, metastasis, circumferential margin involvement as well as complications of intra-operative bleeding, obstruction, anastomosis-fail, rectovaginal-fistula in women and pelvic collection/abscess in both groups, we observed higher rates of locoregional recurrence, incontinency, stenosis and the close distal margins involvement in NOSE group and also obstructed defecation syndrome in TASE cases. Conclusion According to our findings, NOSE laparoscopic surgery showed significantly higher incontinency, impotency, stenosis and involvement of the close distal margins rates. Nevertheless, considering the similarity of long-term overall and recurrence-free survival, metastasis, circumferential margin involvement, NOSE procedure is still could be considered as a second choice for lower rectal adenocarcinoma patients. |
| first_indexed | 2024-03-13T04:53:41Z |
| format | Article |
| id | doaj.art-95a6af58898c4686951c5ce5bdb113f3 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-13T04:53:41Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-95a6af58898c4686951c5ce5bdb113f32023-06-18T11:05:07ZengBMCBMC Surgery1471-24822023-06-012311910.1186/s12893-023-02059-7Laparoscopic surgery for rectal cancer, specimen extraction: transanal or transabdominal?Fatemeh Shahabi0Ala Orafaie1Majid Ansari2Zahra Gholami Moallem 3Ali Mehri4Maryam Hejri Moghadam 5Reza Roshanravan6Abbas Abdollahi7Mahboobeh Rasouli8Endoscopic and Minimally Invasive Surgery research center, Mashhad University of Medical SciencesEndoscopic and Minimally Invasive Surgery research center, Mashhad University of Medical SciencesEndoscopic and Minimally Invasive Surgery research center, Mashhad University of Medical SciencesEndoscopic and Minimally Invasive Surgery research center, Mashhad University of Medical SciencesEndoscopic and Minimally Invasive Surgery research center, Mashhad University of Medical SciencesGhaem Hospital, Mashhad University of Medical SciencesEndoscopic and Minimally Invasive Surgery research center, Mashhad University of Medical SciencesEndoscopic and Minimally Invasive Surgery research center, Mashhad University of Medical SciencesDepartment of Biostatistics, School of Public Health, Iran University of Medical SciencesAbstract Background Comparison of natural orifice specimen extraction (NOSE) and transabdominal specimen extraction (TASE) in colorectal surgery remains controversial. Herein, we aimed to perform a retrospective analysis on surgical outcomes of NOSE and TASE at three hospitals in east of Iran. Method Consecutive locally advanced rectal adenocarcinoma patients who underwent laparoscopic surgery using either NOSE or TASE from 2011 to 2017 were recruited. These patients were followed-up till 2020. Data, including postoperative complications, long-term overall and recurrence-free survival were analyzed retrospectively. Results 239 eligible patients were included in this study. 169 (70.71%) patients underwent NOSE, and 70 (29.29%) patients underwent TASE. Although this study has achieved similar outcomes in terms of overall and recurrence-free survival, metastasis, circumferential margin involvement as well as complications of intra-operative bleeding, obstruction, anastomosis-fail, rectovaginal-fistula in women and pelvic collection/abscess in both groups, we observed higher rates of locoregional recurrence, incontinency, stenosis and the close distal margins involvement in NOSE group and also obstructed defecation syndrome in TASE cases. Conclusion According to our findings, NOSE laparoscopic surgery showed significantly higher incontinency, impotency, stenosis and involvement of the close distal margins rates. Nevertheless, considering the similarity of long-term overall and recurrence-free survival, metastasis, circumferential margin involvement, NOSE procedure is still could be considered as a second choice for lower rectal adenocarcinoma patients.https://doi.org/10.1186/s12893-023-02059-7Rectal cancerLaparoscopySpecimen extractionTransanalTransabdominal |
| spellingShingle | Fatemeh Shahabi Ala Orafaie Majid Ansari Zahra Gholami Moallem Ali Mehri Maryam Hejri Moghadam Reza Roshanravan Abbas Abdollahi Mahboobeh Rasouli Laparoscopic surgery for rectal cancer, specimen extraction: transanal or transabdominal? BMC Surgery Rectal cancer Laparoscopy Specimen extraction Transanal Transabdominal |
| title | Laparoscopic surgery for rectal cancer, specimen extraction: transanal or transabdominal? |
| title_full | Laparoscopic surgery for rectal cancer, specimen extraction: transanal or transabdominal? |
| title_fullStr | Laparoscopic surgery for rectal cancer, specimen extraction: transanal or transabdominal? |
| title_full_unstemmed | Laparoscopic surgery for rectal cancer, specimen extraction: transanal or transabdominal? |
| title_short | Laparoscopic surgery for rectal cancer, specimen extraction: transanal or transabdominal? |
| title_sort | laparoscopic surgery for rectal cancer specimen extraction transanal or transabdominal |
| topic | Rectal cancer Laparoscopy Specimen extraction Transanal Transabdominal |
| url | https://doi.org/10.1186/s12893-023-02059-7 |
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