Transvaginal natural orifice specimen extraction surgery for left-sided colorectal resection: A single-centre cohort study

Xavier, Ruben Gregory and Ke, Tao-Wei and Chen, William Tzu-Liang (2025) Transvaginal natural orifice specimen extraction surgery for left-sided colorectal resection: A single-centre cohort study. Journal of Minimal Access Surgery, 21 (1). pp. 51-59. ISSN 0972-9941, DOI https://doi.org/10.4103/jmas.jmas_108_24.

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Official URL: https://doi.org/10.4103/jmas.jmas_108_24

Abstract

Introduction:Transvaginal natural orifice specimen extraction surgery (NOSES) is an innovative and feasible approach for left-sided colorectal resections in females. This study aimed to report our experience with transvaginal NOSES for left-sided laparoscopic colorectal resections.Patients and Methods:We analysed data for all patients with transvaginal extraction performed for left-sided laparoscopic colorectal resections between 2011 and 2021 at a tertiary teaching hospital in Taiwan.Results:The 18 post-menopausal patients were of a mean age of 69.2 +/- 10.14 years. The lesions were located at the descending (n = 5), sigmoid colon (n = 12) and rectum (n = 1). The operative time was 262.5 +/- 83.91 min, and the blood loss was 34 +/- 35.98 mL. All patients had an end-to-end anastomosis, and the anastomotic height was 15.06 +/- 8.57 cm. Two patients received diversion stoma. The mean length of hospital stay was 5.1 days (standard deviation +/- 2.42; range: 3-12 days). There were no cases of clinical infection. The pathology was malignancy (n = 14, 77.8%), diverticulitis (n = 2, 11.2%) and benign (n = 2, 11.2%). In cancers, they were Stage I (n = 1, 7.1%), IIa (n = 1, 7.1%), IIIb (n = 15, 78.7%) and IV (n = 1, 7.1%). Malignant specimens (n = 14) were mostly moderately differentiated (n = 11, 78.6%), with two poorly differentiated (14.3%) and one well-differentiated (7.1%). The lymph nodes harvested were 16.1 +/- 8.11. The widest dimension of the lesion was 3.43 cm +/- 1.28 (range: 1.5-6) and the length of the specimen was 14.69 cm +/- 5.01 (range: 8-27).Conclusion:Transvaginal NOSES is safe and feasible for left-sided colorectal resection. Factors to consider are the characteristics of the specimen, anal canal and vagina.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Females; left-sided colorectal resection; natural orifice specimen extraction surgery; transvaginal
Subjects: R Medicine > RD Surgery
Divisions: Universiti Malaya Medical Centre (UMMC)
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 13 Mar 2025 02:26
Last Modified: 13 Mar 2025 02:26
URI: http://eprints.um.edu.my/id/eprint/47770

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