Application of natural orifice specimen extraction surgery (NOSES) in ambulatory surgery for rectal cancer

doi:10.3877/cma.j.issn.2095-3224.2024.04.009

Chinese Journal of Colorectal Diseases(Electronic Edition) ›› 2024, Vol. 13 ›› Issue (04): 329-334. doi: 10.3877/cma.j.issn.2095-3224.2024.04.009

• Natural Orifice Specimen Extraction Surgery • Previous Articles Next Articles

Application of natural orifice specimen extraction surgery (NOSES) in ambulatory surgery for rectal cancer

Zhi Zhu¹, Xinwei Zhang¹, Wenfei Tan², Ziming Gao¹, Ruihan Zhao¹, Ye Yang³, Shiyang Wang³, Dongmei Zhi³, Xin Zhao⁴, Changxin Yin⁴, Changyuan Gao⁵, Xishan Wang⁵, Zhenning Wang¹, Kai Li¹^,^†(), Haitao Zhou⁶^,^†()

^1. Department of Gastrointestinal Surgery, National Cancer Regional Medical Center/Cancer Hospital, Chinese Academy of Medical Sciences-Liaoning Hospital, the First Hospital of China Medical University, Shenyang 110001, China
^2. Department of Anesthesia, National Cancer Regional Medical Center/Cancer Hospital, Chinese Academy of Medical Sciences-Liaoning Hospital, the First Hospital of China Medical University, Shenyang 110001, China
^3. Department of Geriatric Surgery, National Cancer Regional Medical Center/Cancer Hospital, Chinese Academy of Medical Sciences-Liaoning Hospital, the First Hospital of China Medical University, Shenyang 110001, China
^4. Department of Operating Room, National Cancer Regional Medical Center/Cancer Hospital, Chinese Academy of Medical Sciences-Liaoning Hospital, the First Hospital of China Medical University, Shenyang 110001, China
^5. Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
^6. Department of Gastrointestinal Surgery, National Cancer Regional Medical Center/Cancer Hospital, Chinese Academy of Medical Sciences-Liaoning Hospital, the First Hospital of China Medical University, Shenyang 110001, China;Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

Received:2024-05-10 Online:2024-08-25 Published:2024-09-02
Contact: Kai Li, Haitao Zhou

Abstract

Abstract:

Objective

To investigate the feasibility and safety of specimen extraction surgery (NOSES) performed in ambulatory surgery for rectal cancer.

Methods

The clinical data of 20 patients with rectal cancer performed by ambulatory surgery from Nov. 1, 2023 to Mar. 31, 2024 admitted to the National Cancer Regional Medical Center-Liaoning Hospital of Cancer Hospital of Chinese Academy of Medical Sciences/the First Affiliated Hospital of China Medical University were retrospectively analyzed and the surgery-related indexes and postoperative complications were collected and analyzed.

Results

In this study, we summarized and analyzed 20 patients with rectal cancer that had been carried out in ambulatory surgery, with no delayed discharge, only one readmission patient, no serious postoperative complications, and patient satisfaction rate was more than 95%.

Conclusion

NOSES combined with ERAS strategy in ambulatory surgery could reduce the surgical incision, stress response and postoperative pain, which is safe and feasible.

Key words: Rectal neoplasms, Ambulatory surgery, Natural orifice specimen extraction surgery (NOSES), ERAS

Zhi Zhu, Xinwei Zhang, Wenfei Tan, Ziming Gao, Ruihan Zhao, Ye Yang, Shiyang Wang, Dongmei Zhi, Xin Zhao, Changxin Yin, Changyuan Gao, Xishan Wang, Zhenning Wang, Kai Li, Haitao Zhou. Application of natural orifice specimen extraction surgery (NOSES) in ambulatory surgery for rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(04): 329-334.

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Figures/Tables 1

References 9

[1]	Robert L, Warner MA. Handbook of ambulatory anesthesia, second edition[J]. Anesthesiology, 2014, 110: 1432.
[2]	嵇武, 刘亚萍, 戴玮. 我国日间手术开展现状与前景展望[J]. 中国实用外科杂志, 2020, 40(2): 199-202.
[3]	Kiran RP, Herman K, Khoshknabi D, et al. Feasibility and safety of ambulatory surgery as the next management paradigm in colorectal resection surgery[J]. Ann Surg, 2022, 276(3):562-569.
[4]	Gignoux B, Gosgnach M, Lanz T, et al. Short-term outcomes of ambulatory colectomy for 157 consecutive patients[J]. Ann Surg, 2019, 270(2): 317-321.
[5]	王玉柳明, 王贵玉. 《中国肿瘤整合诊治技术指南(CACA)·NOSES技术》要点介绍及解读[J]. 结直肠肛门外科, 2023, 29(5): 417-422.
[6]	王锡山. 经自然腔道取标本手术学(第四版)[M]. 北京: 人民卫生出版社, 2021.
[7]	中国医师协会结直肠肿瘤专业委员会,中国抗癌协会大肠癌专业委员会, 中国NOSES联盟. 结直肠肿瘤经自然腔道取标本手术指南(2023版)[J/OL]. 中华结直肠疾病电子杂志, 2023, 12(2): 89-99.
[8]	Lee L, Eustache J, Tran-McCaslin M, et al. North American multicentre evaluation of a same-day discharge protocol for minimally invasive colorectal surgery using mHealth or telephone remote post-discharge monitoring[J]. Surg Endosc, 2022, 36(12): 9335-9344.
[9]	Curfman KR, Poola AS, Blair GE, et al. Ambulatory colectomy: a pathway for advancing the enhanced recovery protocol[J]. J Robot Surg, 2023, 17(3): 827-834.

指标	数值
性别
男	11
女	9
年龄（岁）	51.1±9.6
BMI（kg/m²）	20.8±3.1
新辅助放化疗	7
术前T分期
T1	3
T2	7
T3	10
T4	0
术前N分期
N0	11
N1	9
N2	0
术前M分期
M0	20
M1	0
术前CEA水平/（ng/mL）
<5	17
≥5	3
NRS评分	0.43±0.50
NRS2002评分	1.42±1.06
ECOG评分	0.76±0.72
Caprini评分	1.60±1.18

指标	数值
性别
男	11
女	9
年龄（岁）	51.1±9.6
BMI（kg/m²）	20.8±3.1
新辅助放化疗	7
术前T分期
T1	3
T2	7
T3	10
T4	0
术前N分期
N0	11
N1	9
N2	0
术前M分期
M0	20
M1	0
术前CEA水平/（ng/mL）
<5	17
≥5	3
NRS评分	0.43±0.50
NRS2002评分	1.42±1.06
ECOG评分	0.76±0.72
Caprini评分	1.60±1.18

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[2]	Lixia Zhao, Chunxia Wang, Yifeng Chen, Dongping Hu, Weisheng Zhang, Tao Wang, Honglai Zhang. Effects of visceral obesity on early complications after laparoscopic radical resection for rectal cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 35-39.
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[11]	Jie Chen, Mingsheng Wu, Yijin Li, Hu Li, Yuanchu Xiang, Xinqi Rong, Jian Peng. Preliminary clinical study of cryotherapy for low rectal cancer [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(06): 494-498.
[12]	Haiyang Huang, Yonglong Kuang, Jiasheng Chen. Analysis of 30 cases of natural orifice specimen extraction surgery for colorectal neoplasm in primary hospital [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(06): 510-518.
[13]	Can Wang, Hao Fan, Wei Zhang, Guanyu Yu. A review of the development and current application status of the LARS score [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(06): 519-523.
[14]	Zeyun Zhao, Jiannan Li, Min Wang. Research progress of neutrophil extracellular traps in colorectal cancer [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(06): 524-528.
[15]	Jingting Xu, Lu Kong. Mechanisms of resistance to PARP inhibitors in ovarian cancer and strategies to overcome such resistance [J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(06): 584-588.

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