Long-term outcomes after Natural Orifice Specimen Extraction versus conventional laparoscopy-assisted surgery for rectal cancer: a matched case-control study
10.4174/astr.2018.94.1.26
- Author:
Jun Seok PARK
1
;
Hyun KANG
;
Soo Yeun PARK
;
Hye Jin KIM
;
In Taek LEE
;
Gyu Seog CHOI
Author Information
1. Colorectal Cancer Center, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea. kyuschoi@mail.knu.ac.kr
- Publication Type:Original Article
- Keywords:
Natural Orifice Endoscopic Surgery;
Survival;
Rectal cancer;
Laparoscopy
- MeSH:
Case-Control Studies;
Cohort Studies;
Disease-Free Survival;
Fecal Incontinence;
Follow-Up Studies;
Humans;
Laparoscopy;
Natural Orifice Endoscopic Surgery;
Nose;
Propensity Score;
Prospective Studies;
Rectal Neoplasms;
Recurrence
- From:Annals of Surgical Treatment and Research
2018;94(1):26-35
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The aim of this study was to compare the long-term outcomes of total laparoscopic surgery with Natural Orifice Specimen Extraction (NOSE) with those for conventional laparoscopy (CL)-assisted surgery for treating rectal cancers. METHODS: We reviewed the prospectively collected records of 844 patients (163 NOSE and 681 CL) who underwent curative surgery for mid- or upper rectal cancers from January 2006 to November 2012. We applied propensity score analyses and compared oncological outcomes for the NOSE and CL groups in a 1:1 matched cohort. RESULTS: After propensity score matching, each group included 138 patients; the NOSE and CL groups did not differ significantly in terms of baseline clinical characteristics. The median follow-up was 57.7 months (interquartile range, 42.4–82.5 months). The combined 5-year local recurrence rate for all tumor stages was 4.1% (95% confidence interval [CI], 0.9%–7.4%) in the NOSE group and 3.0% (95% CI, 0%–6.3%) in the CL group (P = 0.355). The combined 5-year disease-free survival rates for all stages were 89.3% (95% CI, 84.3%–94.3%) in the NOSE group and 87.3% (95% CI, 81.8%–92.9%) in the CL group (P = 0.639). The postoperative mean fecal incontinence scores at 6, 12, and 24 months were similar between the 2 groups. CONCLUSION: In our experience, NOSE for mid- and upper rectal cancer had acceptable long-term oncologic outcomes comparable to those of conventional minimal invasive surgery and seems to be a safe alternative to reduce access trauma.
