Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2023; 15(10): 2142-2153
Published online Oct 27, 2023. doi: 10.4240/wjgs.v15.i10.2142
Robotic natural orifice specimen extraction surgery I-type F method vs conventional robotic resection for lower rectal cancer
Fang Tao, Dong-Ning Liu, Peng-Hui He, Xin Luo, Chi-Ying Xu, Tai-Yuan Li, Jin-Yuan Duan
Fang Tao, Dong-Ning Liu, Xin Luo, Chi-Ying Xu, Tai-Yuan Li, Jin-Yuan Duan, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330052, Jiangxi Province, China
Peng-Hui He, Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330052, Jiangxi Province, China
Author contributions: Tao F, Li TY and Duan JY designed the study and reviewed the data; Tao F and Xu CY performed the acquisition of clinical data; Tao F drafting of manuscript; Duan JY and Liu DN critical revision of manuscript; Luo X and He PH data analysis; Luo X figure and video production; All authors read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81860519.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Nanchang University.
Informed consent statement: Patients were not required to give informed consent for this study, as it is a retrospective clinical study and the analysis used previous clinical data. All patients signed an informed consent form before surgery.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Yuan Duan, MD, Associate Chief Physician, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, No. 1519 Dongyue Avenue, Nanchang 330052, Jiangxi Province, China. duanjy2022@outlook.com
Received: March 11, 2023
Peer-review started: March 11, 2023
First decision: June 14, 2023
Revised: July 4, 2023
Accepted: August 18, 2023
Article in press: August 18, 2023
Published online: October 27, 2023
ARTICLE HIGHLIGHTS
Research background

Robotic resection using the natural orifice specimen extraction surgery I-type F method (R-NOSES I-F) is a novel minimally invasive surgical strategy for the treatment of lower rectal cancer with robotic resection of rectal cancer and natural oral specimen extraction surgery. But its safety and feasibility are still worth exploring.

Research motivation

To evaluate the safety and feasibility of R-NOSES I-F for the treatment of lower rectal cancer by comparing R-NOSES I-F with traditional robotic lower rectal cancer resection. To provide a new minimally invasive surgical method for the treatment of lower rectal cancer.

Research objectives

To investigate the safety and feasibility of R-NOSES I-F surgery in the treatment of low rectal cancer.

Research methods

We used retrospective analysis to include 22 patients who underwent R-NOSES I-F surgery into the R-NOSES I-F group and 76 patients who underwent robotic low rectal cancer resection (RLRC) surgery into the RLRC group. The clinicopathological data of all enrolled patients were analyzed to compare the postoperative outcomes and prognosis of the two groups.

Research results

Compared with the RLRC group, the R-NOSES I-F group had a lower visual analog scale of pain on day 1 after surgery (1.7 ± 0.7 vs 2.2 ± 0.6, P = 0.003) and a shorter postoperative ventilation time (2.7 ± 0.6 vs 3.5 ± 0.7, P < 0.001). After long-term follow-up, there was no significant difference in local recurrence rate and distant metastasis rate between the two groups (P > 0.05).

Research conclusions

R-NOSES I-F is a safe and effective minimally invasive procedure for the treatment of lower rectal cancer, which has the advantages of relieving pain, promoting gastrointestinal function recovery, and avoiding incision complications.

Research perspectives

The incidence and mortality of rectal cancer are increasing significantly, and it is particularly important to improve the postoperative quality of life of rectal cancer patients, especially those with low-grade rectal cancer, through improved surgical methods. In recent years, the combination of robotic surgery and NOSES has become one of the hot spots in rectal cancer surgery. R-NOSES I-F has the advantages of reducing postoperative pain, promoting gastrointestinal function recovery, reducing abdominal wall dysfunction, and avoiding complications of abdominal wall incision, and has certain cosmetic effects. It is a safe and effective minimally invasive surgical modality for the treatment of low-lying rectal cancer.