This study aimed to evaluate the effect of laparoscopic resection with natural orifice specimen extraction (NOSE) on short-term outcomes and cellular immunity for colorectal cancer.

From September 2014 to March 2016, data of 89 colorectal cancer patients who underwent laparoscopic resection were reviewed. All included thirty-one patients underwent laparoscopic resection with NOSE (NOSE group), and fifty-eight patients underwent traditional laparoscopic-assisted resection (LAP group). Short-term outcomes and cellular immunity of the patients in the two groups were compared.

The baseline characteristics of the two groups were similar (P>0.05). The two groups did not differ in operating time, perioperative complications and the number of lymph node harvest (P>0.05). Pain score after operation in the NOSE group (2.8±0.9) was significantly lower than those in the LAP group (3.7±1.2) (t=3.766, P<0.001). Times to first flatus were 2.6±0.8 days and 3.3±0.8 days in NOSE group and LAP group, respectively (t=4.427, P<0.001). Postoperative hospital stay in NOSE group were 7.8±4.3 days and 10.3±5.4 days in LAP group, (t=2.213, P=0.030). CD4⁺ T cell counts on the 3rd day after operation were significantly lower than those on the day before operation in both groups,and there were significant differences in CD4⁺ T cell counts on the 3rd day after operation between two groups (t=4.017, P=0.002). CD8⁺ T cell counts and CD4⁺ /CD8⁺ were significantly lower than those on the day before operation in LAP group(P<0.05) but not in NOSE group (P>0.05). CRP level was significantly higher after surgery in both group(P<0.05), and CRP level in the LAP group was significantly higher than that of the NOSE group on the 3rd and the 6th day after surgery (P<0.05).

Compared with traditional laparoscopic-assisted resection, NOSE has better effect of minimally invasive and smaller effect on cellular immunity for colorectal cancer.