Comparative outcomes of natural orifice specimen extraction surgery versus conventional minilaparotomy-assisted specimen extraction in colorectal cancer: A single-center retrospective study.
- 1Department of Colorectal Surgery, The First People's Hospital of Lin'an District, Hangzhou, Zhejiang, China.
Abstract
Natural orifice specimen extraction surgery (NOSES) has emerged as an advanced minimally invasive technique that eliminates abdominal wall incisions for specimen retrieval; nevertheless, comparative data on its efficacy relative to conventional minilaparotomy-assisted extraction in colorectal cancer (CRC) remain limited. This retrospective analysis was conducted on 126 patients who underwent laparoscopic CRC resection at our institution, allocated to either the NOSES group (transanal specimen extraction, n = 49) or the conventional group (minilaparotomy-assisted extraction, n = 77), comparing perioperative parameters, postoperative recovery indicators, complication rates, and pathological outcomes. The NOSES group demonstrated significantly shorter time to first flatus (2.3 ± 0.9 vs 2.9 ± 1.1 days, P = .002), time to first liquid diet (3.1 ± 1.0 vs 3.8 ± 1.3 days, P = .001), and postoperative hospital stay (8.4 ± 3.2 vs 10.1 ± 4.1 days, P = .014). Visual analog scale pain scores on postoperative day 1 were significantly lower in the NOSES group (3.2 ± 1.1 vs 4.5 ± 1.3, P < .001), with reduced additional analgesic requirements (22.4% vs 44.2%, P = .014). Overall complication rates were significantly lower in the NOSES group (12.2% vs 24.7%, P = .043), with wound infections occurring exclusively in the conventional group (0% vs 6.5%, P = .045). No significant differences were observed in operative time, estimated blood loss, anastomotic leakage, lymph node yield, or R0 resection rate (all P > .05). In conclusion, NOSES appears to be a safe and feasible alternative to conventional minilaparotomy-assisted specimen extraction in highly selected patients with CRC, offering advantages in postoperative pain control, gastrointestinal function recovery, and wound-related complication reduction without compromising oncological integrity.
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BibTeX
@article{liao2026comparative,
title = {{Comparative outcomes of natural orifice specimen extraction surgery versus conventional minilaparotomy-assisted specimen extraction in colorectal cancer: A single-center retrospective study.}},
author = {Yongjian Liao and Runfeng Qiu and Wenli Ma},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051179},
url = {https://europepmc.org/article/MED/42888568},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative outcomes of natural orifice specimen extraction surgery versus conventional minilaparotomy-assisted specimen extraction in colorectal cancer: A single-center retrospective study.
AU - Yongjian Liao
AU - Runfeng Qiu
AU - Wenli Ma
PY - 2026
DA - 2026/10/01
JO - Medicine
DO - 10.1097/md.0000000000051179
UR - https://europepmc.org/article/MED/42888568
AB - Natural orifice specimen extraction surgery (NOSES) has emerged as an advanced minimally invasive technique that eliminates abdominal wall incisions for specimen retrieval; nevertheless, comparative data on its efficacy relative to conventional minilaparotomy-assisted extraction in colorectal cancer (CRC) remain limited. This retrospective analysis was conducted on 126 patients who underwent laparoscopic CRC resection at our institution, allocated to either the NOSES group (transanal specimen extraction, n = 49) or the conventional group (minilaparotomy-assisted extraction, n = 77), comparing perioperative parameters, postoperative recovery indicators, complication rates, and pathological outcomes. The NOSES group demonstrated significantly shorter time to first flatus (2.3 ± 0.9 vs 2.9 ± 1.1 days, P = .002), time to first liquid diet (3.1 ± 1.0 vs 3.8 ± 1.3 days, P = .001), and postoperative hospital stay (8.4 ± 3.2 vs 10.1 ± 4.1 days, P = .014). Visual analog scale pain scores on postoperative day 1 were significantly lower in the NOSES group (3.2 ± 1.1 vs 4.5 ± 1.3, P < .001), with reduced additional analgesic requirements (22.4% vs 44.2%, P = .014). Overall complication rates were significantly lower in the NOSES group (12.2% vs 24.7%, P = .043), with wound infections occurring exclusively in the conventional group (0% vs 6.5%, P = .045). No significant differences were observed in operative time, estimated blood loss, anastomotic leakage, lymph node yield, or R0 resection rate (all P > .05). In conclusion, NOSES appears to be a safe and feasible alternative to conventional minilaparotomy-assisted specimen extraction in highly selected patients with CRC, offering advantages in postoperative pain control, gastrointestinal function recovery, and wound-related complication reduction without compromising oncological integrity.
SN - 0304-5412
SN - 1536-5964
ER -