To observe the short mid-term clinical effects of natural orifice specimen extraction surgery (NOSES) in the radical treatment of low rectal cancer.

A retrospective analysis of the clinical datum of 109 patients with low rectal cancer (Tis-T3, N0, M0) who had not undergone preventive sotma from January 2017 to April 2019 was grouped by different surgical procedure. Group A including 57 cases underwent laparoscopic with abdominal incision surgery (Dixon), 25 patients in group B underwent natural orifice specimen extraction surgery (NOSES Ⅰ-A type), and 27 patients in group C underwent natural orifice specimen extraction surgery (NOSES Ⅰ-E type, modified Bacon). The general datum, perioperative indexes, postoperative follow-up assessment of anal function, compications and disease-free survival were compared between the three groups.

BMI was minimal in group B (F=9.62, P＜0.05), and there was no statistical difference in the remaining groups; the tumor position in group C was the lowest (F=18.77, P＜0.05), and there was no statistical difference between the group A and the group B. The groups B and C in hospitalization expenses and the postoperative feed time were no statistical difference with group A (F=8.07, χ²=5.34; P＞0.05), but the group C was better than the group B. The group C was significantly better than other two groups in the time of indwelling catheter and extracted drainage tube (χ²=7.59, F=7.48; P＜0.05), and there was no statistical difference between the group A and the group B. Remainal indicators of perioperative period were no significant difference. The Vaizey scale scores of group A and group B were better than group C at 12 months after surgery (χ²=12.04, P＜0.05), but the scores were not statistically significant at 24 months after surgery (χ²=5.04, P＞0.05). All patients had a complication rate of 26.6%. The group B was 29.65%, which was higher than the group A (26.33%) and group C (20.21%), but there was no statistical difference (χ²=0.48, P＞0.05). There was no patient occurred by local recurrence after 2 years surgery. 2-year disease-free survivals were 94.7%, 96.0% and 88.9% (χ²=1.36, P＞0.05). There was no statistical difference in distant metastasis rate among the three groups (χ²=2.19, P＞0.05).

NOSES is safe and reliable in the radical treatment of low rectal cancer and have a good oncologic prognosis and good preservation of anal function.