To observe the clinical effect of transnasal ileus tube combined with natural orifice specimen extraction surgery (NOSES) in the treatment of obstructive colorectal cancer(OCRC).

A total of 46 OCRC patients were prospectively collected at the Department of General Surgery, No. 988 Hospital of the Joint Logistic Support Force of the Chinese from June 2021 to August 2023. Twenty-three cases in the observation group were treated with transnasal ileus tube combined with NOSES, while 23 cases in the control group were treated with intestinal stent combined with laparoscopic surgery. To describe the operation process of transnasal ileus tube, compare the perioperative data of the two groups and analyze the treatment effects of OCRC.

The observation group were successfully implanted in all 23 patients and 21 cases in the control group were completed. The technical success rate (100% vs. 91.3%) was higher than that of control group, but there was no significant difference (χ²=0.523, P=0.470). Two cases were ineffective in the observation groups and 1 case in the control group. The remission rate (91.3% vs. 95.2%)was no difference between the two groups (χ²=0, P=1.000). The observation group was superior to the control group in operating time (t=-8.064, P<0.001) and complications (P=0.044). The observation group was inferior to the control group in terms of remission time (t=4.530, P<0.001) and exhaust or defecation time (t=14.115, P<0.001). Three cases in the observation group underwent traditional laparoscopic surgery, including 1 case with ileostomy, and the other 18 cases successfully completed NOSES operations. The completion rate of NOSES was 85.7%. all nineteen cases in the control group completed laparoscopic surgery, including 6 cases with ileostomy. The completion rate of laparoscopic surgery was 100%. The rate of primary anastomosis was 100% in the both groups. The observation group was superior to the control group in preoperative preparation time (t=-4.559, P<0.001), ostomy rate (P=0.040), first exhaust time (t=-3.833, P=0.001), postoperative hospitalization time (t=-2.049, P=0.048) and hospitalization expense (t=-4.787, P<0.001). There were no differences in operation time (t=-1.682, P=0.105), bleeding volume (t=-1.815, P=0.078), number of lymph node dissection (t=-1.890, P=0.070) and postoperative complications (χ²=0.223, P=0.637).

The transnasal ileus tube can significantly relieve obstruction symptoms, and avoid intestinal stent defects. It is safe to combine with NOSES and making the treatment of OCRC more economical and minimally invasive.