Clinical efficacy analysis of natural orifice specimen extraction surgery (NOSES) and conventional laparoscopic surgery (CLS) in the treatment of rectal cancer: a single-center retrospective analysis.

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Techniques in Coloproctology Pub Date : 2025-07-13 DOI:10.1007/s10151-025-03186-4

Kai Deng, Yi-Ran Li, Teng-Long Guo, Jun-Zhe Dou, Yu-Liang Cui, Ying-Feng Su

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引用次数: 0

Abstract

Objective: This study aims to compare the clinical efficacy of natural orifice specimen extraction surgery (NOSES) and conventional laparoscopic surgery (CLS) in the treatment of rectal cancer, assessing the advantages and disadvantages of both surgical approaches.

Methods: A propensity score matching (PSM) method was used to analyze 221 patients with rectal cancer treated at Qilu Hospital of Shandong University Dezhou Hospital (Dezhou People's Hospital) from January 2022 to January 2025. The NOSES group included 24 cases, while the CLS group included 197 cases. After 1:1 matching, 46 cases (23 in each group) were included. This study compared surgical time, blood loss, white blood cell count, C-reactive protein (CRP), visual analog scale (VAS) scores, time to passage of flatus, postoperative hospital stay, hospitalization costs, complications, and additional analgesia requirements between the two groups.

Results: The NOSES group showed significant advantages in time to passage of flatus (1.78 ± 0.60 d versus 3.57 ± 1.08 d, P < 0.001), time to get out of bed (1.13 ± 0.34 d versus 1.70 ± 0.47 d, P < 0.001), and VAS scores on postoperative days 1 (1.70 ± 0.56 versus 3.30 ± 1.26, P < 0.001), 3 (1.48 ± 0.51 versus 2.91 ± 1.24, P < 0.001), and 7 (1.13 ± 0.55 versus 2.30 ± 1.36, P < 0.001) compared with the CLS group. The NOSES group also required no additional analgesia (χ² = 9.684, P = 0.002). No significant differences were observed in surgical time, blood loss, or complication rates (P > 0.05).

Conclusions: NOSES effectively alleviates postoperative pain, demonstrates significant minimally invasive advantages, and facilitates short-term patient recovery, highlighting its clinical value.

查看原文本刊更多论文

自然口标本提取术（nose）与常规腹腔镜手术（CLS）治疗直肠癌的临床疗效分析：单中心回顾性分析。

目的：本研究旨在比较自然口标本提取手术（nose）与常规腹腔镜手术（CLS）治疗直肠癌的临床疗效，评估两种手术方式的优缺点。方法：采用倾向评分匹配（PSM）方法对2022年1月至2025年1月在山东大学德州医院齐鲁医院（德州市人民医院）就诊的221例直肠癌患者进行分析。鼻窦组24例，CLS组197例。经1:1匹配，共纳入46例，每组23例。本研究比较了两组患者的手术时间、出血量、白细胞计数、c反应蛋白（CRP）、视觉模拟量表（VAS）评分、排气时间、术后住院时间、住院费用、并发症和额外镇痛需求。结果：鼻窦组在排气时间上有明显优势（1.78±0.60 d vs 3.57±1.08 d, P = 9.684, P = 0.002）。两组手术时间、出血量、并发症发生率无显著差异（P < 0.05）。结论：鼻鼻手术能有效缓解术后疼痛，具有明显的微创优势，并能促进患者短期康复，凸显了鼻鼻手术的临床价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

期刊介绍： Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.