Transanal Specimen Extraction Research Articles

Intracorporeal IPAA After Fully Laparoscopic Total Proctocolectomy With Transanal Specimen Extraction.

Popeskou, Sotirios-Georgios M.D.1,2; Bernardi, Lorenzo M.D.1,2; Christoforidis, Dimitri M.D.1,2 Author Information

Transanal specimen extraction after left-sided laparoscopic colectomy: a systematic review and meta-analysis

To compare the short-term results after left-sided laparoscopic colectomy with transanal and transabdominal specimen extraction. We selected 998 appropriate manuscripts and subsequently excluded 995 ones due to exclusion criteria. Thus, the meta-analysis was based on 3 randomized trials in accordance with PRISMA recommendations. A total of 353 patients were enrolled in meta-analysis including 169 resections with transanal specimen extraction and 184 surgeries with transabdominal extraction. Overall risk of postoperative complications (OR=0.60; 95% CI 0.31-1.14; p=0.12) including anastomotic leakage (OR=1.83; 95% CI 0.43-7.89; p=0.42) was similar in both groups. At the same time, severity of pain syndrome (mean difference = -2.35; 95% CI -2.51-2.19), time to the first flatus discharge (mean difference = -0.92; 95% CI -0.99-0.85) and postoperative hospital stay (mean difference = -1.5; 95% CI -2.03-0.98) were significantly lower in the group of transanal extraction (p<0.00001). Transanal specimen extraction in left-sided laparoscopic colectomy does not increase overall risk of postoperative complications. In addition, the NOSE technique has some advantages in short-term results compared to procedures with transabdominal specimen extraction.

Low Anterior Resection With Transanal Specimen Extraction Using Rectal Eversion Technique.

Low Anterior Resection With Transanal Specimen Extraction Using Rectal Eversion Technique.

Laparoscopic natural orifice specimen extraction, a minimally invasive surgical technique for mid-rectal cancers: Retrospective single-center analysis and single-surgeon experience of selected patients.

To evaluate the feasibility, safety, and short-term outcomes of middle rectal resection followed by transanal specimen extraction. Forty-four patients with small mid-rectal tumors underwent laparoscopic rectal resection followed by transanal specimen extraction. The procedure was successful in all patients without intraoperative conversion or additional access. The mean operation time was 182.7 minutes (range, 130-255 minutes), the mean blood loss was 26.5 mL (range, 5-120 mL), the mean postoperative exhaust time was 31.3 hours (range, 16-60 hours), and the mean length of hospital stay was 9.5 days (range, 8-19 days). One patient developed anastomotic leakage, which was treated by intravenous antibiotics and daily pelvic cavity flushes through the abdominal drainage tube. No infection-related complications or anal incontinence were observed. The mean tumor size was 2.1 cm (range, 1.6-3.2 cm), the mean number of harvested lymph nodes was 16.5 (range, 6-31), and the mean follow-up time was 8.5 months (range, 2-16 months). By the last follow-up, no signs of recurrence had been found in any patient. The combination of standard laparoscopic proctectomy and transanal specimen extraction could become a well-established strategy for selected patients.

Clinical Feasibility and Safety of Trans-anal Specimen Extraction of High Rectal and Sigmoid Cancers

Clinical Feasibility and Safety of Trans-anal Specimen Extraction of High Rectal and Sigmoid Cancers

Commentary on “Laparoscopic Pancreaticoduodenectomy With Transanal Specimen Extraction for Periampullary Tumors”

Annals of Surgery: March 2022 - Volume 275 - Issue 3 - p e599 doi: 10.1097/SLA.0000000000005327

Left colic artery preservation in laparoscopic rectal cancer surgery with transanal natural orifice specimen extraction and extracorporeal anvil placement.

Left colic artery preservation in laparoscopic rectal cancer surgery with transanal natural orifice specimen extraction and extracorporeal anvil placement.

Laparoscopic Pancreaticoduodenectomy With Transanal Specimen Extraction for Periampullary Tumors.

To explore the possibility of LPD with transanal specimen extraction for periampullary tumors. Natural orifice specimen extraction has been widely performed in colorectal surgery. But so far there is no report regarding natural orifice specimen extraction in LPD. Data of 3 patients who underwent LPD with transanal specimen extraction by the same surgeon between July 2018 and March 2019 due to periampullary tumors were evaluated retrospectively. All patients underwent LPD with no conversion to open surgery. Specimens were all extracted transanally. No complications occurred except for delayed gastric emptying in 1 patient. The patients' anorectal function was intact and no opioids were required postoperatively. After a follow-up of 17-25 months, all patients were alive with no tumor recurrence. Treatment of periampullary tumors by LPD with transanal specimen extraction is feasible and safe.

Robotic sigmoidectomy for diverticulitis - Natural orifice extraction with stapleless hand-sewn intracorporeal anastomosis.

A sigmoidectomy is the most definitive surgical treatment for recurrent diverticulitis. While it is usually accomplished via transabdominal specimen extraction and stapled anastomosis, the robotic platform can facilitate novel approaches and techniques. This is the first report of the initial experience using robotic sigmoidectomy with natural orifice specimen extraction and hand-sewn anastomosis (NOSHA). A prospectively maintained database of NOSHA procedures performed between 2018 and 2020 was retrospectively examined. The technique was described and variables across preoperative, intra-operative and postoperative timeframes were presented. The Clavien-Dindo classification system was used to describe postoperative complications. Sixteen patients with recurrent diverticulitis treated with NOSHA were included in this study. Transanal specimen extraction and an intracorporeal hand-sewn anastomosis were achieved in all patients. However, two (12.8%) patients required specimen debulking prior to extraction. The mean operating time was 171.7min, and patients had a return of bowel function within an average period of 35.2h. The mean hospital length of stay was 2.9days. In total, two (12.8%) complications were seen: one postoperative ileus managed conservatively and one readmission for abdominal pain which resolved without intervention. No anastomotic leaks or reoperations were observed. Robotic NOSHA appears to be a viable technique for the surgical management of diverticulitis. Further studies are needed to establish its utility for various diseases and its reproducibility across clinical practices.

A modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection for upper rectal or lower sigmoid colon cancer: a retrospective study

BackgroundIn recent years, natural orifice specimen extraction surgery (NOSES) has become a field of special interest for colorectal surgeons. Some researchers have reported transanal specimen extraction in the laparoscopic anterior rectal resection, including intersphincteric resection (ISR) and rectal eversion-resection. However, these surgical procedures have certain limitations. Based on the proven expertise in laparoscopic surgery, our center has developed a modified technique of transanal specimen extraction. The aim of this study was to investigate the safety and feasibility of a modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection.MethodsFrom January 2011 to January 2014, the patients with upper rectal or lower sigmoid colon cancer who had undergone laparoscopic anterior rectal resection with specimen extraction by a modified transanal technique were enrolled in the observation group, and the patients who had undergone laparoscopic anterior rectal resection with specimen extraction via an abdominal incision by the same surgeons during the same period were enrolled in the control group.ResultsA total of 36 patients were included in the observation group and 128 patients were included in the control group. There were no significant differences (P > 0.05) between the two groups in terms of the mean operative time [144 ± 10 min vs. 141 ± 11 min], mean intraoperative blood loss [63 ± 6 ml vs. 61 ± 7 ml], and the mean time to anal exhaust [67 ± 7 h vs. 65 ± 8 h]. However, there were significant differences (P < 0.05) between the two groups in terms of the mean postoperative Visual Analogue Scale (VAS) pain scores [3.4 ± 1.1 vs. 4.5 ± 1.2], mean postoperative hospital stay [6.0 ± 1.1 days ± vs. 7.2 ± 1.2 days], and incidence of postoperative complications (4/36 vs. 15/128). Long-term follow-up results showed that there was no significant difference (P > 0.05) between the two groups in terms of the 3- or 5-year overall survival.ConclusionsThe modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection fulfilled the principle of no-neoplasm touch technique, with advantages, such as minimal trauma, rapid recovery, and fewer complications. Long-term follow-up results also showed satisfactory oncological outcomes.

Totally Robotic Sigmoidectomy with Trans-anal Specimen Extraction and Intra- corporeal, Single Stapler, End-to-End Anastomosis

Totally Robotic Sigmoidectomy with Trans-anal Specimen Extraction and Intra- corporeal, Single Stapler, End-to-End Anastomosis

Precision functional sphincter-preserving surgery (PPS) for ultralow rectal cancer: a natural orifice specimen extraction (NOSE) surgery technique.

In patients with ultralow rectal cancer, surgical resection of the tumor without impairing sphincter function remains a technical challenge. The purpose of this study was to describe a new technique of transanal natural orifice specimen extraction (NOSE) surgery using our independently developed devices, aiming to achieve precise cancer resection and preserve sphincter function in patients with ultralow rectal cancer. Precision functional sphincter-preserving surgery (PPS) was performed on nineteen patients with ultralow rectal cancer between June 2019 and April 2020. With the help of our independently developed devices, surgeons directly and accurately removed the lower edge of the tumor and retained healthy rectal tissue on the nontumorous side. Hand-sewn anastomosis with a mattress suture was used to achieve sturdy anastomosis. Preoperative baseline characteristics, operative details, 90-day postoperative complications, costs, and analfunctionscore at 6 months after surgery were documented. Nineteen ultralow rectal cancer patients with a median distance to the dentate line of 2.0 cm successfully underwent PPS without serious postoperative complications. Six out of nineteen patients (31.6%) received a prophylactic stoma. The average cost was 62164.1 yuan. At 6 months after surgery, the average Wexner anal function score and the average Vaizey score were both 3 points. PPS can be employed to precisely resect rectal tumors and preserve sphincter function in ultralow rectal cancer patients. The use of our devices enhanced surgical efficiency, reduced the need for prophylactic stoma, reduced surgery-related costs, and prevented abdominal surgical incisions.

Effect of laparoscopic surgery for colorectal cancer with N. O. S. E. on recovery and prognosis of patients

Objective To investigate the effect of laparoscopic surgery in colorectal cancer (CRC) patients with natural orifice specimen extraction (NOSE) on the recovery and quality of life (QOL) of patients. Material and methods Ninety-two eligible patients were randomly assigned into two groups: the traditional laparoscopy group (L group, n = 46) and the laparoscopic transanal specimen extraction group (NL group, n = 46). General data, surgery-related indicators, postoperative recovery, and prognosis were compared and analyzed between the two groups. Results A total of 46 patients in each group were enrolled in this study. The general data and surgery-related indicators were comparable between the two groups (all p > .05). There were no significant differences in the time of first flatus, bleeding, obstruction, constipation, and infectious complications between the two groups (all p > .05). The differences in the incidence of postoperative diarrhea, pain degree, and satisfaction on the aesthetics of the abdominal wall showed significant differences (χ2 = 6.133, p = .013; χ2 = 12.116, p = .017; χ2 = 13.463, p = .004). The postoperative follow-up time was 3–53 months. There were no significant differences in the postoperative hospital stay, medical costs, hospital readmission rate, incidence of incisional hernia, overall survival, disease-free survival, and QOL between the two groups (all p > .05). Conclusion: Laparoscopic surgery with NOSE for eligible patients with CRC was a feasible choice.

Nghiên cứu ứng dụng phẫu thuật nội soi lấy bệnh phẩm đường tự nhiên trong điều trị ung thư trực tràng

Tóm tắt Đặt vấn đề: Phẫu thuật nội soi qua đường tự nhiên (NOTES: Natural orifice transluminal endoscopic surgery) và phẫu thuật nội soi truyền thống nhưng lấy bệnh phẩm qua ngả tự nhiên (Hybrid NOTES) là bước phát triển mới trong phẫu thuật ít xâm lấn điều trị ung thư đại trực tràng. Song nó vẫn chưa được phát triển rộng rãi trên thế giới cũng như ở Việt Nam. Nghiên cứu này nhằm mục đích đánh giá kết quả bước đầu phẫu thuật cắt ung thư trực tràng nội soi lấy bệnh phẩm qua đường tự nhiên. Phương pháp nghiên cứu: nghiên cứu tiến cứu. Đối tượng nghiên cứu gồm 32 người bệnh ung thư biểu mô tuyến trực tràng giai đoạn T≤3, N≤1, M0 được phẫu thuật từ 10/2012 đến 09/2015 tại BVTW Huế. Phương pháp nghiên cứu: phẫu thuật được tiến hành trên hai phương thức Hybrid NOTES(A) và NOTES(B) với ba kỹ thuật: cắt trước (AR: anterior resection), trước thấp (LAR: low anterior resection) và xuyên cơ thắt (Pull-through). Kết quả: Tất cả 32 người bệnh đều được phẫu thuật thành công cắt ung thư trực tràng nội soi lấy bệnh phẩm qua đường tự nhiên, không có trường hợp nào phải chuyển mổ mở. 3 trường hợp trong nhóm NOTES có tai biến chảy máu và thủng niệu đạo, phải đặt thêm trocar hỗ trợ và không có trường hợp nào tử vong. Thời gian phẫu thuật nhóm Hybrid NOTES là 194±47(120-280) phút, nhóm NOTES là 258±40(190-300) phút. Thời gian nằm viện: 9±2,7(4-19) ngày. Kết luận: Phẫu thuật cắt ung thư trực tràng nội soi lấy bệnh phẩm qua đường tự nhiên bước đầu cho thấy khả thi và an toàn trên cả hai phương thức: phẫu thuật nội soi đường bụng lấy bệnh phẩm qua ngả tự nhiên Hybrid NOTES và phẫu thuật hoàn toàn qua lỗ tự nhiên NOTES. Abstract Introduction: Transanal extraction of specimen by laparoscopic surgery for rectal cancer composed of Natural Orifice Transluminal Endoscopic Surgery (NOTES) and Hybrid NOTES nowadays is an important evaluation in minimally invasive for colorectal cancer surgery. However, it has not implemented commonly on over the world. This research is to evaluate the outcome of the technique in treatment of rectal cancer. Material and Methods: Prospective study was conducted from 10/2012 to 09/2015 in 32 patients diagnosed with rectal adenocarcinoma staging T≤3, N≤1, M0 and were operated using one of two modalities Hybrid NOTES (A) and NOTES (B) with three techniques: AR, LAR and Pull-through. Results: Thirty-two patients with rectal cancer were successfully operated by Hybrid NOTES and NOTES procedures. Three cases in group NOTES that had per-operative complications such as bleeding or urethra injury were required one or two additional trocars to complete the procedure, no conversion to open surgery and no mortality. The operation duration: group A (Hybrid NOTES): 194±47 (120-280) minutes; group B (NOTES): 258±40 (190-300) minutes. The length of hospital stay: 9±2.7 (4-19) days. Conclusion: Laparoscopic rectal resection with natural orifice specimen extraction for rectal cancer composed of Natural orifice transluminal endoscopic surgery (NOTES) and Hybrid NOTES is feasible and safe. However, a study in a large number of patient and long follow-up is necessary. Keyword: Natural orifice transluminal endoscopic surgery (NOTES), Hybrid NOTES, rectal cancer.

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

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.

Transanal versus transabdominal specimen extraction in laparoscopic rectal cancer surgery: a retrospective analysis from China.

IntroductionComparison of transanal specimen extraction (TSE) and transabdominal specimen extraction (TASE) in laparoscopic rectal surgery is still sparsely reported. Trauma, pain, scarring, and bad psychological suggestion have long been considered an inevitable outcome of surgery. For laparoscopic rectal cancer surgery, whether TSE or TASE is beneficial in terms of technical platforms, indications, contraindications, technical requirements for aseptic operation, tumor-free operation, prevention and treatment of complications still has not reached a unified consensus and standards. Recently, comparison of TSE and TASE in laparoscopic rectal surgery has still been sparsely reported.AimIn this study, we retrospectively analyzed the short-term outcomes of TSE and TASE in laparoscopic rectal surgery in a single institution in southern China.Material and methodsPatients who underwent laparoscopic radical rectal cancer surgery using either TSE or TASE were recruited. Data, including patient demographics, perioperative and postoperative variables, were analyzed retrospectively.ResultsSixty-seven patients were included in this study. Thirty patients underwent TSE and 37 patients underwent TASE. The two groups were similar in demographics and tumor characteristics. Postoperative complications were similar in both groups, except that wound infection was lower for the TSE group (p = 0.122). The TSE group had a better cosmetic result with no abdominal incision and no differences in circumferential margins, distal resection margins or completeness of total mesorectal excision.ConclusionsLaparoscopic TSE is recommended in the treatment of rectal cancer with similar oncologic outcomes compared with conventional TASE. It is mini-invasive surgery and has the advantage of better cosmetic results. There is a need for further randomized studies to refine the applicability of laparoscopic TSE in rectal cancer.

Clinical efficacy of transanal specimen extraction in modified Da Vinci robot-assisted anterior resection of rectosigmoid tumor

Objective To explore the clinical efficacy of transanal specimen extraction in modified Da Vinci robot-assisted anterior resection of rectosigmoid tumor. Methods The retrospective cross-sectional study was conducted. The clinicopathological data of 47 patients who underwent Da Vinci robot-assisted anterior resection of rectosigmoid tumor using transanal specimen extraction in the Second Xiangya Hospital of Central South University from March to October 2016 were collected. Excisional intestinal canal was intraoperatively taken out from the anus instead of abdominal minor incision. Observation indicators: (1) operation and postoperative recovery; (2) postoperative pathological examination situations; (3) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients and tumor recurrence or metastasis up to June 2017. Measurement data with normal distribution were represented as ±s. Results (1) Operation and postoperative recovery: 47 patients underwent successful operations, without conversion to open surgery. Of 47 patients, 8 underwent coloanal ultralow anastomosis, 3 underwent prophylactic terminal ileum stoma fistulization and 1 underwent intersphincteric resection after turning inside out resectable specimen. Operation time, volume of intraoperative blood loss, time for out-of-bed activity, time to anal exsufflation and time of postoperative drainage-tube removal were (222±73)minutes, (21±9)mL, (1.7±0.8)days, (2.3±1.0)days and (6±5)days, respectively. Among 3 patients with postoperative complications, 2 with anastomotic fistula were cured by conservative treatment, and 1 with urinary retention removed urethra catheter at 4 weeks postoperatively. All the 47 patients had good recovery, and duration of hospital stay was (10±4)days. (2) Postoperative pathological examination situations: number of lymph node dissected was 15±7, with R0 resection. Tumor pathological diagnosis: rectosigmoid adenocarcinoma was detected in 38 patients (1 with high-differentiated tumor, 32 with moderate-differentiated tumor and 5 with low-differentiated tumor), mixed carcinoma in 4 patients, tubulovillous adenoma in 2 patients, mucinous adenocarcinoma in 1 patient, neuroendocrine carcinoma in 1 patient and focal carcinoma in 1 patient. The maximum diameter of tumor was (3.5±1.5)cm. Postoperative pathological T stage: 4, 9, 18 and 14 patients were detected in stage T1, T2, T3 and T4a. Postoperative pathological N stage: 30, 8 and 7 patients were detected in stage N0, N1 and N2. Postoperative pathological TNM stage: stage Ⅰ, Ⅱ and Ⅲ were respectively in 11, 19 and 15 patients. There was no clinical stage in 2 patients with tubulovillous adenoma. (3) Follow-up: of 47 patients, 42 were followed up for 7-15 months, with a median time of 11 months. During the follow-up, 38 patients had tumor-free survival, 3 had tumor recurrence or metastases and 1 died. Conclusion Transanal specimen extraction is safe and feasible in modified Da Vinci robot-assisted anterior resection of rectosigmoid tumor, with minimal invasion and satisfactory short-term outcomes. Key words: Colorectal neoplasms; Da Vinci robot surgical system; Radical resection; Transanal; Specimen

Comfortable nursing during the perioperative period for patients undergoing laparoscopic-assisted radical left colectomy transanal specimen extraction

Objective To probe into the perioperative comfortable nursing methods after laparoscopic-assisted natural orifice sampling in radical operation for left colorectal cancer. Methods The study summarized the experiences of comfortable nursing during the perioperative period for 31 patients who underwent the laparoscopic-assisted radical left colectomy transanal specimen extraction with the Cai Tube.The key points of the comfortable nursing included the regular care during the perioperative period, preoperative psychological nursing, sufficient preoperative anal sphincter exercises and preparation for bowel, comfortable nursing for anal function and gastrointestinal tract and intensive education and follow-up services after discharge and so on. Results Complications such as great vascular, intestinal and parenchyma organ injuries, as well as intraoperative transfer to open surgery were not seen in the 31 cases of patients receiving LA-NOSE. All the patients had excellent postoperative recovery, with no incision complication or anus function injury, and they were discharged after rehabilitation. Conclusion LA-NOSE combined with conventional nursing and comfortable nursing can obtain satisfying clinical nursing quality. Key words: Natural tract specimens; Cai Tube; Radical left colectomy; Cooperation in the surgery; Comfortable nursing

Unlimited-Length Proctocolectomy Utilizing Sequential Intussusception and Pull-Through: Novel Clean Endolumenal NOTE-Assisted Technique With Transanal Natural Orifice Specimen Extraction Without Rectal Stump Opening in a Porcine Model.

Transanal, hybrid natural orifice translumenal endoscopic surgery (NOTES) and NOTES-assisted natural orifice specimen extraction techniques hold promise as leaders in the field of natural orifice surgery. We report the feasibility of a novel NOTES assisted technique for unlimited length, clean, endolumenal proctocolectomy in a porcine model. This technique is a modification of a transanal intussusception and pull-through procedure recently published by our group. Rectal mobilization was achieved laparoscopically; this was followed by a transanal recto-rectal intussusception and pull-through (IPT). IPT was established in a stepwise fashion. First, the proximal margin of resection was attached laparoscopically to the shaft of the anvil of an end-to-end circular stapler with a ligature around the rectum. Second, this complex was pulled transanally to produce IPT. To achieve an unlimited-length proctocolectomy, the IPT step was repeated several times prior to bowel resection. This was facilitated by removing the ligature applied in the first step of this procedure. Once sequential IPT established the desired length of bowel to be resected, a second ligature was placed around the rectum approximating the proximal and distal resection margins. The specimen was resected and extracted by making a full-thickness incision through the 2 bowel walls. The anastomosis was achieved by deploying the stapler. The technique was found to be feasible. Peritoneal samples, collected after transanal specimen extraction, did not demonstrate bacterial growth. The minimally invasive nature of this evolving technique as well as its aseptic bowel manipulation has the potential to limit the complications associated with abdominal wall incision and surgical site infection.

Propensity score matching-based analysis of short-term outcomes of Laparoscopic-assisted Natural Orifice Specimen Extraction for left colorectal cancer radical resection

To explore short-term outcomes obtained with Laparoscopic-assisted Natural Orifice Specimen Extraction for left colorectal cancer radical resection. A total of 123 patients with left colorectal tumor who had undergone laparoscopic surgery between Jan.2014 and Jun.2015 were reviewed. According to surgical approach, transanal specimen extraction using the Cai Tube (study group, n=29) and trans-abdominal incision specimen extraction (control group, n=123) were studied. Propensity score matching was applied at a ratio of 1∶1 comparing the study (n=23) and control (n=23) groups. The two matched groups had similar baseline characteristics. There was no significant difference in the length of distal or proximal resection margin, the rate of circumferential resection negative margin, the estimated blood loss, the levels of C-reactive protein on 2nd day after surgery, the postoperative time to take liquid, the postoperative hospital day, the hospital fee and the postoperative anal function. The study group presented longer operative time[(237.8±68.1)min vs (168.9±47.5)min, P<0.05], less number of lymph nodes dissected (12.4±5.4 vs 16.4±7.2, P<0.05), higher white cell count on 2nd day after surgery[(11.7±3.4)×10(9)/L vs (9.4±2.6)×10(9)/L, P<0.05], but quicker postoperative recovery of bowel function[(2.6±0.7)d vs (3.4±0.7)d, P<0.05], shorter postoperative ambulation time[(2.3±0.6)d vs (3.6±0.7)d, P<0.05], lower rate of postoperative complications (0/23 vs 6/23, P<0.05) and lower rate of utilization of painkillers in addition to postoperative analgesia pump (1/20 vs 9/23, P<0.05). Laparoscopic-assisted left colorectal cancer radical resection using the Cai Tube is in line with oncologic principle, less pain, quicker recovery and better cosmetic results.