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Updates in Surgery
Published in: Updates in Surgery 2/2022

01-04-2022 | Colorectal Cancer | Original Article

Natural orifice specimen extraction surgery versus conventional laparoscopic-assisted resection for colorectal cancer in elderly patients: a propensity-score matching study

Authors: Hao Zhang, Hanqing Hu, Rui Huang, Zilong Guan, Mingyu Zheng, Chao Xu, Zhengliang Li, Yuliuming Wang, Weiyuan Zhang, Lei Yu, Yinghu Jin, Qingchao Tang, Guiyu Wang, Xishan Wang

Published in: Updates in Surgery | Issue 2/2022

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Abstract

Whether natural orifice specimen extraction surgery (NOSES) could provide beneficial effects in treating elderly patients is still under debate. The aim of the study was to compare the clinical outcomes of transanal NOSES with conventional laparoscopic-assisted resection (LA) in elderly colorectal cancer (CRC) patients. A retrospective analysis from the Second Affiliated Hospital of Harbin Medical University between 2013 and 2017 was performed. Outcomes related to surgery, body image, quality of life, anal function and long-term survival were compared between the two groups with the propensity-score matching (PSM) method. After PSM, 78 patients were successfully compared. Patients with NOSES had faster gastrointestinal function recovery (P = 0.028), less postoperative complications (P = 0.025), lower pain scores on days 1, 3 and 5 after surgery (P < 0.001). The body image score (P < 0.001) and cosmetic score (P < 0.001) were significantly higher in the NOSES group than the LA group at 1 month after surgery. Patients with NOSES posed better global health status (P < 0.001), role function (P = 0.009), emotional function (P = 0.011) and social function (P = 0.011) at 3 months after surgery. Moreover, NOSES showed non inferiority in anal function 6 months after surgery. No significant difference could be found regarding to overall survival (OS), disease-free survival (DFS), local recurrence (LR) and distant metastasis (DM). In elderly CRC patients, NOSES harbored favorable postoperative outcomes, excellent cosmetic properties and better quality of life. Besides, anal function and long-term outcomes of NOSES can be sure for elderly patients.
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Metadata
Title
Natural orifice specimen extraction surgery versus conventional laparoscopic-assisted resection for colorectal cancer in elderly patients: a propensity-score matching study
Authors
Hao Zhang
Hanqing Hu
Rui Huang
Zilong Guan
Mingyu Zheng
Chao Xu
Zhengliang Li
Yuliuming Wang
Weiyuan Zhang
Lei Yu
Yinghu Jin
Qingchao Tang
Guiyu Wang
Xishan Wang
Publication date
01-04-2022
Publisher
Springer International Publishing
Published in
Updates in Surgery / Issue 2/2022
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-021-01143-y

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