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Techniques in Coloproctology
Published in: Techniques in Coloproctology 4/2017

01-04-2017 | Original Article

Success rate of natural orifice specimen extraction after laparoscopic colorectal resections

Authors: S. Karagul, C. Kayaalp, F. Sumer, I. Ertugrul, S. Kirmizi, A. Tardu, M. A. Yagci

Published in: Techniques in Coloproctology | Issue 4/2017

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Abstract

Purpose

To date, no data have been available to inform which cases are appropriate for natural orifice specimen extraction (NOSE) after laparoscopic colorectal resections (LCRRs). Our aim was to evaluate the success rate and the factors affecting the failure in patients who were scheduled for NOSE after LCRRs.

Methods

Seventy-two consecutive cases that were intended for NOSE after LCRR were enrolled. The transanal route was always chosen as the first option, and when it failed, the transvaginal route was tried in female patients. If both failed, the specimen was judged as unsuitable for NOSE and removed through an abdominal wall incision. Demographic data, surgical indications, resection localization, implemented procedures, incision sites, specimen extraction methods, specimen sizes, and failures of NOSE were recorded.

Results

A total of 349 colorectal resections (240 open and 109 laparoscopic) in a 3-year period were examined. The subset of 72 consecutive patients who met the criteria were analyzed. Five cases required a conversion to open surgery during resections. In the remaining 67 patients, NOSE after LCRR was successful in 49 cases (73.1%) but failed in 18 (26.9%). Specimens were extracted from transanal and transvaginal routes in 37 (75.5%) and 12 (24.5%) patients, respectively. The failure rate of NOSE after LCRR was higher in males, in colonic lesions, and in large-sized tumors. The mean sizes of transanal and transvaginal extracted specimens were 3.5 ± 3.1 and 5.4 ± 1.4 cm, respectively (p < 0.05). The mean size of the tumors in the failed cases was 6.5 ± 4.2 cm (p < 0.05).

Conclusions

Approximately 2/3 of the unselected LCRRs were suitable for NOSE. The success rate increased with female gender, small-sized tumors, and rectal resections.
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Metadata
Title
Success rate of natural orifice specimen extraction after laparoscopic colorectal resections
Authors
S. Karagul
C. Kayaalp
F. Sumer
I. Ertugrul
S. Kirmizi
A. Tardu
M. A. Yagci
Publication date
01-04-2017
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 4/2017
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-017-1611-2

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