To demonstrate the safety and feasibility of natural orifice specimen extraction surgery (NOSES) by comparing the efficacy and prognosis between NOSES and conventional laparoscopic surgery for left colon cancer patients.

127 left colon cancer patients who underwent surgery in the Second Affiliated Hospital of Harbin Medical University from May 2013 to May 2017 were enrolled. Collecting clinical data, includes demographic data, surgical data, short-term and long-term follow-up data. The general data of the patients was matched by the propensity score matching method 1∶1. The data was retrospectively analyzed.

After propensity score matching forty-eight patients underwent NOSES and 48 patients underwent laparoscopic surgery. Compared with laparoscopic surgery, NOSES resulted in significantly better short-term prognosis in postoperative exhaust time (Z=-2.539, P=0.011), postoperative feeding time (Z=-4.117, P＜0.001), postoperative hospital stay days (Z=-5.846, P＜0.001), postoperative pain score of the first day (Z=9.565, P＜0.001), third day (Z=12.885, P＜0.001), fifth day (Z=7.053, P＜0.001) and seventh day (Z=2.537, P=0.014). European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTCQLQ-C30) was applied to evaluate long-term prognosis of two groups, indicating the NOSES group was significantly better in general health condition (Z=-4.808, P＜0.001), role function (Z=-2.476, P=0.013), emotional function (Z=-3.075, P=0.002), cognitive function (Z=-2.423, P=0.015), and social function (Z=-3.639, P＜0.001). However, there was no statistically significant difference with regards to anal functional Parks score, postoperative complications, and survival analysis (all P＞0.05).

The safety of NOSES operation is no less than that of laparoscopic surgery. Moreover, NOSES operation is superior to conventional laparoscopic surgery in some aspects of postoperative recovery. Therefore, the NOSES operation is safe and feasible.