{"title":"高BMI结直肠癌患者自然孔口标本提取手术的结果：倾向评分匹配研究","authors":"Chenkai Zhang, Hao Zhang, Wenyang Li, Songtao Yu, Haonan Qi, Chunlin Wang, Ibatullin Artur, Guiyu Wang","doi":"10.3389/fsurg.2025.1624266","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Natural orifice specimen extraction surgery (NOSES) is widely used for colorectal cancer. However, there is limited study regarding the outcomes of patients with high BMI who undergo NOSES surgery for colorectal cancer.</p><p><strong>Methods: </strong>This retrospective study included 251 patients (including 205 Non-High BMI and 46 High BMI patients) who underwent NOSES for colorectal cancer between January 2013 and December 2018. Outcomes related to surgery, anal function and long-term survisval were compared between the Non-High BMI and High BMI patients with the propensity-score matching (PSM) method. Age, gender, tumor location (sigmoid/rectum), preoperative CEA, CA199, T stage and N stage were considered as covariates for PSM.</p><p><strong>Results: </strong>After matching, 44 patients in the Non-High BMI group and 44 patients in the High BMI group were eligible for analysis. No significant differences were observed between the groups in terms of operative time, blood loss, time to first flatus, time to first diet, postoperative hospital stays, positive margin, postoperative complication, conversion to open surgery and pathological outcomes (all <i>P</i>-value > 0.05). Besides, there was no significant difference for anal function 6 months after surgery between the two groups (<i>P</i> = 0.723). The overall survival (OS) and disease-free survival (DFS) for the Non-high BMI group were comparable to those for the High BMI group (<i>P</i> = 0.156 for OS, <i>P</i> = 0.266 for DFS).</p><p><strong>Conclusion: </strong>With careful preoperative evaluation, High-BMI patients can successfully undergo NOSES surgery and achieve favorable outcomes.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1624266"},"PeriodicalIF":1.6000,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410070/pdf/","citationCount":"0","resultStr":"{\"title\":\"Outcomes of high BMI colorectal cancer patients with natural orifice specimen extraction surgery: a propensity-score matching study.\",\"authors\":\"Chenkai Zhang, Hao Zhang, Wenyang Li, Songtao Yu, Haonan Qi, Chunlin Wang, Ibatullin Artur, Guiyu Wang\",\"doi\":\"10.3389/fsurg.2025.1624266\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Natural orifice specimen extraction surgery (NOSES) is widely used for colorectal cancer. However, there is limited study regarding the outcomes of patients with high BMI who undergo NOSES surgery for colorectal cancer.</p><p><strong>Methods: </strong>This retrospective study included 251 patients (including 205 Non-High BMI and 46 High BMI patients) who underwent NOSES for colorectal cancer between January 2013 and December 2018. Outcomes related to surgery, anal function and long-term survisval were compared between the Non-High BMI and High BMI patients with the propensity-score matching (PSM) method. Age, gender, tumor location (sigmoid/rectum), preoperative CEA, CA199, T stage and N stage were considered as covariates for PSM.</p><p><strong>Results: </strong>After matching, 44 patients in the Non-High BMI group and 44 patients in the High BMI group were eligible for analysis. No significant differences were observed between the groups in terms of operative time, blood loss, time to first flatus, time to first diet, postoperative hospital stays, positive margin, postoperative complication, conversion to open surgery and pathological outcomes (all <i>P</i>-value > 0.05). Besides, there was no significant difference for anal function 6 months after surgery between the two groups (<i>P</i> = 0.723). The overall survival (OS) and disease-free survival (DFS) for the Non-high BMI group were comparable to those for the High BMI group (<i>P</i> = 0.156 for OS, <i>P</i> = 0.266 for DFS).</p><p><strong>Conclusion: </strong>With careful preoperative evaluation, High-BMI patients can successfully undergo NOSES surgery and achieve favorable outcomes.</p>\",\"PeriodicalId\":12564,\"journal\":{\"name\":\"Frontiers in Surgery\",\"volume\":\"12 \",\"pages\":\"1624266\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-08-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410070/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fsurg.2025.1624266\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2025.1624266","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景：自然孔口标本提取术（nose）广泛应用于结直肠癌。然而，关于高BMI患者接受鼻手术治疗结直肠癌的结果的研究有限。方法：本回顾性研究纳入2013年1月至2018年12月期间接受鼻治结直肠癌的251例患者（包括205例非高BMI患者和46例高BMI患者）。采用倾向评分匹配（PSM）方法比较非高BMI和高BMI患者的手术、肛门功能和长期生存相关结果。年龄、性别、肿瘤位置（乙状结肠/直肠）、术前CEA、CA199、T分期和N分期作为PSM的协变量。结果：匹配后，44例非高BMI组患者和44例高BMI组患者符合分析条件。两组在手术时间、出血量、首次排气时间、首次饮食时间、术后住院时间、阳性切缘、术后并发症、转开腹手术及病理结果方面均无显著差异（p值均为0.05）。两组术后6个月肛门功能比较差异无统计学意义（P = 0.723）。非高BMI组的总生存期（OS）和无病生存期（DFS）与高BMI组相当（OS P = 0.156, DFS P = 0.266）。结论：术前仔细评估，高bmi患者可以顺利进行鼻外科手术并获得良好的预后。
Outcomes of high BMI colorectal cancer patients with natural orifice specimen extraction surgery: a propensity-score matching study.
Background: Natural orifice specimen extraction surgery (NOSES) is widely used for colorectal cancer. However, there is limited study regarding the outcomes of patients with high BMI who undergo NOSES surgery for colorectal cancer.
Methods: This retrospective study included 251 patients (including 205 Non-High BMI and 46 High BMI patients) who underwent NOSES for colorectal cancer between January 2013 and December 2018. Outcomes related to surgery, anal function and long-term survisval were compared between the Non-High BMI and High BMI patients with the propensity-score matching (PSM) method. Age, gender, tumor location (sigmoid/rectum), preoperative CEA, CA199, T stage and N stage were considered as covariates for PSM.
Results: After matching, 44 patients in the Non-High BMI group and 44 patients in the High BMI group were eligible for analysis. No significant differences were observed between the groups in terms of operative time, blood loss, time to first flatus, time to first diet, postoperative hospital stays, positive margin, postoperative complication, conversion to open surgery and pathological outcomes (all P-value > 0.05). Besides, there was no significant difference for anal function 6 months after surgery between the two groups (P = 0.723). The overall survival (OS) and disease-free survival (DFS) for the Non-high BMI group were comparable to those for the High BMI group (P = 0.156 for OS, P = 0.266 for DFS).
Conclusion: With careful preoperative evaluation, High-BMI patients can successfully undergo NOSES surgery and achieve favorable outcomes.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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