Short-term outcomes of colorectal cancer treatment after natural orifice specimen extraction surgery (NOSES) and with conventional laparoscopy

Introduction. Colorectal cancer (CRC) is one of the most common malignancies in the world.

The purpose of the study. To evaluate the short-term results of laparoscopic operations with extraction of the surgical preparation through natural openings (NOSES) and mini-laparotomy (CL) in the surgical treatment of colorectal cancer.

Materials and methods of research. A prospective analysis was carried out in the Department of Faculty Surgery № 2 of Sechenov University. Preoperative and postoperative clinical variables of both patient groups were recorded and compared.

Treatment results. The study presents data on 50 patients with verified malignancies in the colon and rectum who underwent laparoscopic surgery with mini-laparotomy or through natural orifices. Fewer patients in the NOSES group received neoadjuvant chemotherapy vs CL group (4 % vs 40 %, p=0,002), the operative time in the NOSES group was shorter vs CL group (254.60±54.39 min vs 304,76±105,39, p=0,040), intraoperative bleeding was less in the NOSES group vs CL group (61,60±40,49 ml vs 132,00±149,92 ml, p=0,028). After surgery, patients in the NOSES group had faster gastrointestinal recovery (1,56±1,19 days vs. 2,68±1,75 days, p=0,011), earlier first postoperative bowel movement (2,16±1,31 days vs. 3,08±1,80 days, p=0,044), and shorter hospital stay (6,04±1,97 days vs. 7,24±1,67 days, p=0,024), lower pain indices on the first, third and fifth postoperative days (2,92±2,08 vs. 4,08±1,73, p=0,037), (2,56±1,66 vs. 3,84±1,68, p=0,009), (1,84±1,84 vs. 3,80±1,71, p<0,001).

Conclusion. This study provides insight into the efficacy and safety of NOSES compared to conventional laparoscopic interventions with mini-laparotomy. The results suggest a potential advantage of this technique, but requires further analysis for a comprehensive evaluation.

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