Retrospective study of 718 colorectal neoplasms treated by natural orifice specimen extraction surgery in 79 hospitals

Objective To study the application status and feasibility of natural orifice specimen extraction surgery (NOSES) in colorectal neoplasms by collecting the NOSES cases in 79 hospitals around China. Methods A total of 718 cases of NOSES were collected. The data of patients included demographic data, surgical data, postoperative pathology and follow-up data. Results The average age of patients was 59.4±10.8 years, the average BMI is 22.9±6.3 kg/m2, 72.3% of patients received rectal NOSES, and 3.5% of patients received neoadjuvant therapy. Pathological results showed that patients in stage I~IV were 31.3%, 26.8%, 30.8% and 0.8% respectively. The proportion of adenocarcinoma was 62.1%, the average diameter of tumor was 4.1±1.8 cm, and the number of lymph nodes was 13.4±3.5. In this study, 76.2% of patients underwent laparoscopic anterior resection combined with NOSES. 90.4% of the patients were treated with rectal specimen extractions and 9.6% by vaginal extractions. The average operation time was 210.5±39.4 minutes, the average blood loss was 61.8±23.1 ml, the average postoperative exhaust time was 44.5±10.3 hours, and the time of postoperative feeding time was 64.9±14.6 hours, the average of postoperative hospital stay was 12.1±4.0 days, the incidence of complications was 10.6%, postoperative anal dysfunction accounted for 1.5% of the total, no vaginal dysfunction was detected. Conclusion NOSES in colorectal neoplasms is widely carried out in China and has shown great potential for promotion. At the same time, NOSES surgery followed the requirement of tumor radical surgery, presenting with good short-term effect. Therefore, this technology is a safe and reliable minimally invasive surgery. Key words: Colorectal neoplasms; Natural orifice specimen extraction surgery; Laparoscopic surgery; Minimally invasive surgery