Clinical comparative study and discussion between NOSES surgery and traditional laparoscopic surgery for colorectal cancer

Abstract

Objective In recent years, guided by the theory of minimally invasive surgery, the NOSES operation for colorectal cancer has demonstrated the advantages of minimally invasive surgery compared with traditional laparoscopy surgery, but its safety and feasibility still need to be studied and discussed more widely. Methods The data of 30 patients with colorectal cancer who underwent conventional laparoscopic or NOSES surgery from Mar. to Jun. 2019 at the China Medical University has been collected, retrospectively. T test and Fisher′s exact test were used in the study. The differences of intraoperative and postoperative parameters between patients undergoing two different surgical procedures were analyzed. Results The data showed that there was no significant difference in the amount of blood loss (P=0.639) and the number of lymph node dissection (P=0.524) between the two groups, but there was significant difference in the average operation time (P=0.004). The average operation time was(228.1±69.58)min in the NOSES group and (160.25±48.83)min in the conventional laparoscopic group (P=0.004). In terms of short-term prognosis, there was no significant difference in the incidence of postoperative complications between the two groups, including postoperative fever (P=0.584) , diarrhea (P=0.657), pancreatitis (P=1.000), lymphatic leakage (P=0.540) , intestinal obstruction (P=0.532) , bleeding (P=1.000) and cardiac insufficiency (P=1.000). There was no significant difference in data between the two groups in terms of postoperative hospitalization, such as postoperative exhaust time (P=0.418), average length of stay (P=0.593), average total cost (P=0.848) and rehospitalization rate (P=0.333). Conclusions The retrospective data suggested that NOSES operation for colorectal cancer has no significant difference in safety and efficacy compared with conventional laparoscopic surgery, what’s more, the NOSES operation can avoid abdominal wall incision and postoperative scarring. NOSES operation for colorectal cancer is worthy of further study and promotion. Key words: Colorectal cancer; NOSES; Natural orifice specimen extraction surgery; Laparoscopy