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Chinese Journal of Colorectal Diseases(Electronic Edition) ›› 2017, Vol. 06 ›› Issue (06): 469-477. doi: 10.3877/cma.j.issn.2095-3224.2017.06.006

Special Issue: ； ； ；

• Original Article • Previous Articles     Next Articles

Retrospective study of 718 colorectal neoplasms treated by natural orifice specimen extraction surgery in 79 hospitals

Xu Guan1, Guiyu Wang2, Zhuqing Zhou3, Haitao Zhou1, Yinggang Chen2, Qingchao Tang2, Junmin Song2, Jianchun Cai2, Chuanqing Bao2, Hong Zhang2, Yanjun Liu2, Zhiguo Xiong2, Miao Wu2, Chun Song2, Yangchun Zheng2, Jia Rui Jiang2, Su Yan2, Yong Wang2, Qinglin Hu2, Dan Ma2, Ke Ren2, Dehai Xiong2, Xinghong Zhang2, Mingrui Yang2, Yuekui Bai2, Wei Fu2, Shuhua Li2, Shifeng Zhang2, Jungang Liu2, Xianwei Mo2, Hongyan Gong2, Bo Jiang2, Tie Wang2, Anping Zhang2, Ping Zhu2, Tao Fu2, Junhong Hu2, Wenzhuo Jia2, Changjiang Qin2, Qi Su2, Daorong Wang2, Wanqing Wu2, Zonggang Zhao2, Hongbo Zhu2, Wuyong Jin2, Changqing Jing2, Degang Li2, Wenzhi Liu2, Zhichun Liu2, Liming Pang2, Dong Tang2, Xiaoqiang Wang2, Guoshan Yang2, Kunhou Yao2, Xueming Zhang2, Lei Zhao2, Xiaogang Zhong2, Lei Zhou2, Zhou Zhu2, Xuefeng Bai2, Chaowu Chen2, Shiwei Chen2, Zehua Chen2, Ling Dai2, Zhenbao Fu2, Feng Gao2, Hao Gao2, Lei Gao2, Jianfeng Gong2, Yong Jiang2, Jiansheng Zheng2, Weisen Jin2, Dechuan Li2, Jun Li2, Hongwei Lin2, Baolin Liu2, Chunqing Liu2, Ming Liu2, Jianbin Meng2, Jian Qiu2, Gui’an Rao2, Donghui Sun2, Xuejun Sun2, Jiandong Ji2, Zhigang Wang2, Guangwei Xie2, Ming Xie2, Ye Wei2, Jun Yan2, Likun Yan2, Feng Yang2, Heming Yang2, Wanjun Yang2, Luchuan Chen2, Zaizheng Ye2, Zhige Yu2, Zhonghai Zhao2, Ming Zhong2, Yuping Zhu2, Chuangang Fu3,†(), Xishan Wang1,†()   

  1. 1. Department of Colorectal Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China;China NOSES Alliance, Beijing 100021, China
    2. China NOSES Alliance, Beijing 100021, China
    3. China NOSES Alliance, Beijing 100021, China;Department of Gastrointestinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
  • Received:2017-10-12 Online:2017-12-25 Published:2017-12-25
  • Contact: Chuangang Fu, Xishan Wang
  • About author:
    Corresponding author: Wang Xishan, Email:
    Fu Chuangang, Email:

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Abstract:

Objective

To study the application status and feasibility of natural orifice specimen extraction surgery (NOSES) in colorectal neoplasms by collecting the NOSES cases in 79 hospitals around China.

Methods

A total of 718 cases of NOSES were collected. The data of patients included demographic data, surgical data, postoperative pathology and follow-up data.

Results

The average age of patients was 59.4±10.8 years, the average BMI is 22.9±6.3 kg/m2, 72.3% of patients received rectal NOSES, and 3.5% of patients received neoadjuvant therapy. Pathological results showed that patients in stage I~IV were 31.3%, 26.8%, 30.8% and 0.8% respectively. The proportion of adenocarcinoma was 62.1%, the average diameter of tumor was 4.1±1.8 cm, and the number of lymph nodes was 13.4±3.5. In this study, 76.2% of patients underwent laparoscopic anterior resection combined with NOSES. 90.4% of the patients were treated with rectal specimen extractions and 9.6% by vaginal extractions. The average operation time was 210.5±39.4 minutes, the average blood loss was 61.8±23.1 ml, the average postoperative exhaust time was 44.5±10.3 hours, and the time of postoperative feeding time was 64.9±14.6 hours, the average of postoperative hospital stay was 12.1±4.0 days, the incidence of complications was 10.6%, postoperative anal dysfunction accounted for 1.5% of the total, no vaginal dysfunction was detected.

Conclusion

NOSES in colorectal neoplasms is widely carried out in China and has shown great potential for promotion. At the same time, NOSES surgery followed the requirement of tumor radical surgery, presenting with good short-term effect. Therefore, this technology is a safe and reliable minimally invasive surgery.

Key words: Colorectal neoplasms, Natural orifice specimen extraction surgery, Laparoscopic surgery, Minimally invasive surgery

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