Alternative specimen extraction techniques complimenting enhanced recovery after surgery protocol in gastrointestinal malignancies: An early experience

Abstract

Background Minimally invasive surgery is being increasingly implemented for Gastrointestinal (GI) malignancies. Site of specimen extraction after surgery influence the postoperative course by adding up-to the parietal wound morbidity. We studied the effect of alternative specimen extraction techniques on postoperative recovery and ease of implementation of ERAS protocol. Results A single center prospective data of 32 patients were compiled and the alternative specimen extraction sites studied were Natural Orifice Specimen Extraction-Vagina (n=8), Proposed Stoma Site Specimen Extraction (n=19), Trans Anal Specimen Extraction (n=5). All the patients had ease in the implementation of ERAS protocol and showed enhance recovery after the surgery with minimal wound related morbidity. The average duration of stay in the hospital was 5.8 days (SD=1.4) and the time to start adjuvant therapy when needed was an average of 21.7 days (SD= 5.46). Conclusion Alternative Specimen extraction techniques other than routine laparotomy compliment ERAS protocol initiation and implementation in patients undergoing Minimally invasive GI Oncological Surgery.