A Case Series of Laparoscopic Colorectal Resections with Natural Orifice Specimen Extraction and Systematic Literature Review
Background Minimal access surgery is associated with improved cosmetic and other short-term outcomes. Conventionally, an abdominal incision is made for specimen extraction. We assessed the feasibility of specimen extraction through one of the natural orifices and analyzed its impact on short-term ou...
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doaj-f9ad10faa467473f9e171f8e15b3a1862021-08-03T22:59:50ZengThieme Medical Publishers, Inc.The Surgery Journal2378-51282378-51362021-07-010703e203e20810.1055/s-0041-1733833A Case Series of Laparoscopic Colorectal Resections with Natural Orifice Specimen Extraction and Systematic Literature ReviewNasir Zaheer Ahmad0Ray Swayamjoti1Karen Flashman2Syed Abul Hassan Naqvi3Jim Khan4Department of General Surgery, University Hospital Limerick, Limerick, IrelandDepartment of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth, United KingdomDepartment of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth, United KingdomDepartment of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth, United KingdomDepartment of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth, United KingdomBackground Minimal access surgery is associated with improved cosmetic and other short-term outcomes. Conventionally, an abdominal incision is made for specimen extraction. We assessed the feasibility of specimen extraction through one of the natural orifices and analyzed its impact on short-term outcomes. Methods A prospectively collected data were reviewed on consecutive patients who underwent natural orifice specimen extraction (NOSE) after laparoscopic colorectal surgery. The results were compared with a matched group who had transabdominal extraction (TAE) of the specimens. A systematic literature review was performed to compare our results. Results The combined median operating time for right and left colectomies was significantly higher in the NOSE group as compared with TAE group (260 vs. 150). There was no mortality in either group and no conversions to TAE in the NOSE group. No local metastasis or major iatrogenic injuries were reported at the time of retrieval. The results were comparable to those of a meta-analysis of randomized controlled trials. Conclusion The results of NOSE are comparable to those of TAEs. The absence of a minilaparotomy for specimen extraction may lead to a speedy recovery and better cosmesis.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1733833minimal access surgerynatural orifice specimen extractioncosmetic |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nasir Zaheer Ahmad Ray Swayamjoti Karen Flashman Syed Abul Hassan Naqvi Jim Khan |
spellingShingle |
Nasir Zaheer Ahmad Ray Swayamjoti Karen Flashman Syed Abul Hassan Naqvi Jim Khan A Case Series of Laparoscopic Colorectal Resections with Natural Orifice Specimen Extraction and Systematic Literature Review The Surgery Journal minimal access surgery natural orifice specimen extraction cosmetic |
author_facet |
Nasir Zaheer Ahmad Ray Swayamjoti Karen Flashman Syed Abul Hassan Naqvi Jim Khan |
author_sort |
Nasir Zaheer Ahmad |
title |
A Case Series of Laparoscopic Colorectal Resections with Natural Orifice Specimen Extraction and Systematic Literature Review |
title_short |
A Case Series of Laparoscopic Colorectal Resections with Natural Orifice Specimen Extraction and Systematic Literature Review |
title_full |
A Case Series of Laparoscopic Colorectal Resections with Natural Orifice Specimen Extraction and Systematic Literature Review |
title_fullStr |
A Case Series of Laparoscopic Colorectal Resections with Natural Orifice Specimen Extraction and Systematic Literature Review |
title_full_unstemmed |
A Case Series of Laparoscopic Colorectal Resections with Natural Orifice Specimen Extraction and Systematic Literature Review |
title_sort |
case series of laparoscopic colorectal resections with natural orifice specimen extraction and systematic literature review |
publisher |
Thieme Medical Publishers, Inc. |
series |
The Surgery Journal |
issn |
2378-5128 2378-5136 |
publishDate |
2021-07-01 |
description |
Background Minimal access surgery is associated with improved cosmetic and other short-term outcomes. Conventionally, an abdominal incision is made for specimen extraction. We assessed the feasibility of specimen extraction through one of the natural orifices and analyzed its impact on short-term outcomes.
Methods A prospectively collected data were reviewed on consecutive patients who underwent natural orifice specimen extraction (NOSE) after laparoscopic colorectal surgery. The results were compared with a matched group who had transabdominal extraction (TAE) of the specimens. A systematic literature review was performed to compare our results.
Results The combined median operating time for right and left colectomies was significantly higher in the NOSE group as compared with TAE group (260 vs. 150). There was no mortality in either group and no conversions to TAE in the NOSE group. No local metastasis or major iatrogenic injuries were reported at the time of retrieval. The results were comparable to those of a meta-analysis of randomized controlled trials.
Conclusion The results of NOSE are comparable to those of TAEs. The absence of a minilaparotomy for specimen extraction may lead to a speedy recovery and better cosmesis. |
topic |
minimal access surgery natural orifice specimen extraction cosmetic |
url |
http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1733833 |
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