Randomized clinical trial of laparoscopic colectomy with or without natural-orifice specimen extraction

The British Journal of Surgery
Albert M WolthuisAndré D'Hoore

Abstract

Although conventional laparoscopic colectomy is a validated technique, laparoscopic natural-orifice specimen extraction (NOSE) colectomy might improve outcome. This randomized clinical trial compared analgesia requirements, postoperative pain, anorectal function, inflammatory response and cosmesis in laparoscopic NOSE colectomy and conventional laparoscopic colectomy. Patients were randomly assigned to undergo laparoscopic NOSE colectomy or conventional laparoscopic colectomy for left-sided colonic disease. The primary endpoint was analgesia requirement. Secondary endpoints were operative outcome, inflammatory response, anorectal function and cosmesis. Forty patients were enrolled in the study, 20 in each group (15 with diverticulitis and 5 with colorectal cancer in each group). A significant difference was observed in morphine analogue requirements (1 of 20 patients in the NOSE group versus 10 of 20 in the conventional group; P = 0·003). Patient-controlled epidural analgesia was lower in the NOSE group (mean 116 ml versus 221 ml in the conventional group; P < 0·001), as was paracetamol use (mean 11·0 versus 17·0 g respectively; P < 0·001). Postoperative pain scores were lower in the NOSE group: mean maximum visual analogue sco...Continue Reading

References

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Citations

Sep 12, 2015·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Antonino Spinelli, Isacco Montroni
Mar 30, 2016·Updates in Surgery·Dario ScalaPaolo Delrio
Aug 19, 2015·Journal of the American College of Surgeons·Sebastian H LammDaniel C Steinemann
Apr 18, 2016·Journal of the American College of Surgeons·Daniel C SteinemannSebastian H Lamm
Jun 14, 2017·The British Journal of Surgery·D C SteinemannG R Linke
Jun 14, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·H ZhouC Ruan
Dec 9, 2016·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·D C SteinemannS H Lamm
Jun 28, 2018·Techniques in Coloproctology·D ZattoniD Christoforidis
Feb 23, 2019·Gastroenterology Report·Xu GuanUNKNOWN International Alliance of NOSES
Jul 22, 2017·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Hideharu ShimizuJun Matsumoto
Nov 10, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Zimin ZhaoEnhong Zhao
Nov 6, 2020·Journal of Gastroenterology and Hepatology·Ben HuangChuan-Gang Fu
May 12, 2021·Scientific Reports·Hongliang YaoJiangjiao Zhou
May 13, 2021·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Zimin ZhaoEnhong Zhao
Oct 4, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Bor-Kang JongJeng-Fu You

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