Brief Insight about Natural Orifice Specimen Extraction in Management of Colorectal Cancer

Abstract

Surgical treatment for colorectal cancer has advanced rapidly within recent years. Changes to minimally invasive surgery include the addition of natural orifice specimen extraction (NOSE) to conventional laparoscopic approaches to further limit the incisional burden on the patient. Traditionally, with laparoscopic surgery for right-sided colon cancers, specimen extraction is performed through an additional abdominal incision. With the pronounced effort to reduce these incisions, NOSE became prominent in the recent decade. Previous studies have shown favorable postoperative outcomes and short-term oncologic outcomes in the setting of sigmoid and rectal cancer removal. Additionally, transvaginal NOSE was also shown to be beneficial for removal of right-sided colon cancers but was limited to female patients. Natural orifice specimen extraction surgery (NOSES) is an actively developing approach for extracting specimens and performing non-incisional colorectal cancer surgery. Previous studies have shown that its effectiveness and safety in the surgical treatment of rectal cancer are similar to those of conventional laparoscopic surgery. NOSES was demonstrated to be a possible alternative approach to conventional laparoscopy, for which a mini-laparotomy is used to extract the specimen, as there were no differences in surgical characteristics and short-term outcomes.