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Transanal natural orifice specimen extraction in colorectal surgery: bacteriological and oncological concerns
Author(s) -
Ngu James,
Wong Andrew Siang Yih
Publication year - 2016
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13383
Subject(s) - medicine , surgery , colorectal surgery , perioperative , nose , laparoscopy , anastomosis , laparoscopic surgery , anal canal , colorectal cancer , endoscopy , general surgery , rectum , abdominal surgery , cancer
Natural orifice techniques have been developed to reduce incision‐related morbidity in laparoscopic colorectal surgery. We describe our method of performing transanal specimen extraction in laparoscopic colorectal surgery, addressing bacteriological and oncological concerns in its implementation. Methods Data of consecutive patients undergoing natural orifice specimen extraction ( NOSE ) laparoscopic colorectal surgery in our institution were retrospectively analysed. All specimens were extracted transanally via a wound protector, followed by intracorporeal end‐to‐end colorectal anastomosis. Perioperative details, microbiological and oncological findings were reviewed. Results Between N ovember 2014 and F ebruary 2015, five patients underwent NOSE laparoscopic colorectal procedures in our institution. All cases were completed laparoscopically and specimens were extracted transanally via a wound protector. There were no cases of post‐operative anastomotic leaks, wound infections, intra‐abdominal sepsis or faecal incontinence. Oncological margins and lymph node harvest were adequate for malignant cases. Transanal specimen extraction did not result in a malignant yield on peritoneal fluid cytology. Conclusions Early bacteriological, oncological and functional results show that NOSE is safe and feasible. Follow‐up is required to establish that long‐term oncological outcome is not compromised.