To explore the effect of mesentery prior, pulling and pushing method for NOSESⅠ in lower rectal cancer patients with obesity or fat mesentery.

This is a retrospective analysis of 55 patients with rectal cancer admitted to Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, between January 2017 and December 2020. All patients received NOSESⅠ. The following were recorded: duration of surgery, intraoperative blood loss, the number of lymph nodes harvested, the maximum diameter of the tumor, the distance of the inferior resection margin, the length of the excised bowel, duration of hospitalization and complication. And the safety and effectiveness of the operation was explored.

Surgery was successfully finished in all 55 patients with mesentery prior, pulling and pushing method. There are 41 patients with BMI between 24 and 28 kg/m², and 14 patients with BMI between 28 and 33 kg/m².The median duration of surgery was 180 min (84 min, 339 min), the median intraoperative blood loss was 30 mL (10 mL, 200 mL),the median number of lymph nodes harvested was 18 (9, 45), the median maximum diameter of the tumor was 3 cm (1 cm, 7 cm), the median distance of the inferior resection margin was 2 cm (1 cm, 3 cm), the median length of the excised bowel was 11 cm (7.5 cm, 29 cm), the median exhaust time was 2 d (1 d, 5 d), the median duration of hospitalization was 7 d (4 d, 22 d) and complication rate was 5.5% (3/55).

Mesentery prior, pulling and pushing method for NOSES in rectal cancer patients with obesity or fat mesentery was safe and effective.