Natural orifice specimen extraction versus conventional laparoscopically assisted right hemicolectomy

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Right-sided colonic cancer treatment often involves hemicolectomy.
• Minimally invasive techniques aim to improve patient outcomes and reduce morbidity.
• Natural orifice specimen extraction (NOSE) is an evolving technique in laparoscopic surgery.

Purpose of the Study:

• To compare the clinical outcomes of totally laparoscopic hemicolectomy with NOSE versus conventional laparoscopically assisted surgery for right-sided colonic cancer.
• To evaluate short-term surgical outcomes, including pain, hospital stay, morbidity, and cosmetic results.
• To assess the feasibility and safety of the NOSE approach in this patient cohort.

Main Methods:

• A case-control study design was employed.
• Patients undergoing totally laparoscopic right hemicolectomy with transvaginal NOSE were matched with those undergoing conventional laparoscopically assisted procedures.
• Clinicopathological characteristics were used for matching, and outcomes were compared between the two groups.

Main Results:

• Thirty-four patients were analyzed in each group.
• The NOSE group reported significantly lower pain scores on postoperative days 1 and 3.
• Patients in the NOSE group experienced a shorter hospital stay and reported significantly better cosmetic results.
• While surgical morbidity was lower in the NOSE group, the difference was not statistically significant.
• No transvaginal access-site recurrences or posterior colpotomy-related complications were observed during follow-up.

Conclusions:

• The natural orifice specimen extraction (NOSE) approach is a feasible surgical option for right-sided colonic cancer.
• NOSE is associated with favorable short-term surgical outcomes, including reduced pain, shorter hospital stays, and improved cosmesis.
• Further investigation into long-term outcomes and broader application of NOSE is warranted.