Related Experiment Video
Updated: Sep 11, 2025
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
Natural Orifice Specimen Extraction Surgery yields superior long-term oncological outcomes compared to traditional
Yanle Fang1, Lin Lin1, Hongxun Ruan1
1Department of General Surgery, The Second Hospital of Hebei Medical University No. 215, Heping West Road, Shijiazhuang 050000, Hebei, China.
Objectives:
To compare the long-term oncological and clinical outcomes of natural orifice specimen extraction surgery (NOSES) versus traditional laparoscopic surgery (TLS) in patients with Stage II-III rectal cancer.
Methods:
This retrospective cohort study analyzed data from 320 patients who underwent curative resection for Stage II-III rectal cancer between January 2020 and January 2025. Of these, 162 received NOSES and 158 underwent TLS. Perioperative outcomes, postoperative recovery, complications, disease-free survival (DFS), overall survival (OS), recurrence and metastasis rates, and quality of life were evaluated. Multivariate analyses were performed to identify independent prognostic factors for long-term outcomes.
Results:
Compared with TLS, NOSES resulted in shorter operative times and less intraoperative blood loss (both P < 0.001). Patients in the NOSES group experienced faster return of bowel function and shorter hospital stays (both P < 0.001). At five-year follow-up, NOSES was associated with significantly improved DFS (P = 0.014), OS (P = 0.009), and higher quality of life scores (P < 0.001). The NOSES group also exhibited fewer postoperative complications and a lower incidence of distant metastasis (P = 0.034). Multivariate analysis identified NOSES as an independent predictor of improved long-term survival and quality of life.
Conclusions:
NOSES offers significant advantages over TLS in the management of Stage II-III rectal cancer, including enhanced operative efficiency, accelerated recovery, reduced complications, and superior long-term oncological outcomes and quality of life. These findings support the wider clinical adoption of NOSES as a preferred minimally invasive surgical approach in eligible rectal cancer patients.
