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Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
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Left colon resection with transrectal specimen extraction: current status
D Zattoni1, G S Popeskou2, D Christoforidis3
1Department of General Surgery, Ospedale per gli Infermi di Faenza, 48018, Faenza, Italy. davide.zattoni@auslromagna.it.
Techniques in Coloproctology
|June 28, 2018
Summary
Transrectal specimen extraction (TRSE) for laparoscopic colectomy is a feasible and safe minimally invasive surgical technique. While outcomes appear comparable to conventional laparoscopic colectomy, further high-quality trials are needed to confirm potential benefits in pain and hospital stay.
Area of Science:
- Minimally Invasive Surgery
- Colorectal Surgery
- Surgical Innovation
Background:
- Laparoscopic colectomy is a standard minimally invasive surgical approach.
- Transrectal specimen extraction (TRSE) is an emerging technique for left-sided colectomy and upper rectum resection.
- This review examines the current status and outcomes of TRSE.
Purpose of the Study:
- To review the current status of left-sided colectomy and upper rectum resection using transrectal specimen extraction (TRSE).
- To analyze surgical techniques, patient characteristics, and outcomes associated with TRSE.
- To evaluate the feasibility, safety, and potential benefits of TRSE compared to conventional laparoscopic colectomy.
Main Methods:
- Systematic review of publications on colorectal resection with natural orifice specimen extraction (NOSE).
- Inclusion criteria focused on left colectomy, sigmoidectomy, and high anterior resection with transrectal specimen extraction (TRSE).
- Exclusion of transanal, transvaginal, or transcolonic specimen extraction methods.
Main Results:
- Thirty-five papers reported on TRSE, including randomized trials, case-matched series, and case reports.
- Conversion rate to conventional laparoscopy was 3.7% (21/559) and overall morbidity was 9.5% (53/559).
- No mortality was reported; postoperative anal incontinence was rare, with potential decreases in pain and hospital stay observed.
Conclusions:
- Transrectal specimen extraction (TRSE) is a feasible and safe approach for selected patients undergoing colectomy.
- Outcomes appear similar to conventional laparoscopic colectomy, with potential advantages in postoperative pain and length of hospital stay.
- Lack of high-quality trials and inherent selection bias limit definitive conclusions.
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