Measurement of the circumferential diameter of tumor specimen and its distal intestinal cavity during laparoscopic surgery for colorectal cancer with specimen pulled out through the rectum

doi:10.3877/cma.j.issn.1674-6899.2022.06.004

Abstract

Abstract:

Objective

To explore the clinical value of circumferential diameter measuring of the tumor specimen and its distal intestinal cavity during laparoscopic surgery for colorectal cancer patients with specimen pulled out through the rectum after resection inside the body (NOSES).

Methods

31 patients with colorectal cancer who underwent laparoscopic surgery with an intention to pull out specimen through the rectum after body-inside resection in the Department of Gastrointestinal Surgery of Sichuan Cancer Hospital from Mar. 2020 to Mar. 2022 were prospectively included. The circumferential diameter of distal intestinal cavity and the tumor specimen were measured during the operation. The relation between the difference (△) and the feasibility and difficulty of specimen pulling-out was analyzed.

Results

Among the 31 patients, NOSES was successfully completed on 20 cases, of whom the specimen of 13 patients was taken out easily and the specimen of 7 cases was taken out with some difficulty. The other 11 patients who were unable to pull out the specimen through the rectum, therefore, were converted to routine laparoscopic surgery. All patients recovered smoothly after surgery. None anastomotic leakage was observed. The average postoperative hospital stay was (9.9 ± 1.80) days. The average value of △ in patients with specimen easily pulling-out was (2.54±1.63) cm, and in patients with specimen pulling-out with difficulty was (0.74±0.79) cm, and in patients with specimen unable to pull out was (-4.11±1.96) cm. The correlation analysis showed that △ value was negatively correlated with the difficulty of specimen retraction through the rectum (r=-0.835, P< 0.001).

Conclusions

The measurement of the circumferential diameter of the distal intestinal cavity and the tumor specimen during laparoscopic colorectal surgery with specimen pulling-out through the rectum after resection inside the body truly reflects the volume of the specimen retraction channel and the size of the tumor specimen. The measurement method is simple and easy, which helps to evaluate the feasibility and predict the difficulty of specimen retraction, and is worth further clinical promotion.

Key words: Laparoscopic, Colorectal cancer, Natural orifice specimen extraction surgery, Feasibility of specimen extraction, Evaluation

Chao Deng, Chao Chen, Bo Yi, Wuyi Wang, Qi Guo, Bin Zhao, Chuanchuan Fu, Yuanyi Rui, Yangchun Zheng. Measurement of the circumferential diameter of tumor specimen and its distal intestinal cavity during laparoscopic surgery for colorectal cancer with specimen pulled out through the rectum[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2022, 15(06): 336-340.

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References 19

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