Abstract 3963
Background
As an emerging technique, natural orifice specimen extraction surgery(NOSES) can avoid abdominal incision and improve cosmetic outcomes. However, the robotic application in NOSES for colorectal surgery is scarcely investigated.
Methods
For present study, all the colorectal specimen was transanally extracted. NOSES was classified into two types as following:1) Transanal eversion and extracorporal resection technique, which is mainly used for resection of lower and middle rectal cancer. 2) Intra-abdominal specimen resection and transanal extraction technique, which is mainly used for upper or middle rectal resection and sigmoid colectomy.
Results
Between October 2013 and March 2019, there were 155 patients with colorectal cancer undergoing robot-assisted NOSES. All the procedures were performed successfully without emergency requiring conversion to open surgery. The maximum diameter of rectal lesions was average 3.9±1.7cm, and distance to the lower edge of the lesion from the anal verge was measured to be 8.4±3.9 cm. The operating time for the entire procedures including rectal eversion, resection and anastomosis was 169.1±40.3 min, and blood loss during the procedures was 41.6±34.7 ml. Moreover, there were 16.1±5.7 lymph nodes dissected, and length to distal resection margin from tumor lower border was 1.7±0.9cm. Postoperatively, patients began first flatus and resumed fluid diet average 2.2±0.8 days and 1.3±0.3 days after surgery. Duration of postoperative hospital stay was median 7 days, while 12 patients developed anastomotic leakage, and both managed with conservative treatment. Median 15-month follow-up of all the 155 patients was performed to assess the middle/short term outcomes. During the follow-up period, there is no abdominal infection, pelvic abscess and other severe infectious complication for bacteriological outcome. For functional outcome, no dysuria, sexual function disorder and fecal incontinence were found among all the patients. Importantly, none of 155 patients were dead, and 8 patients were observed local recurrence or distant metastasis.
Conclusions
Robotic NOSES for colorectal cancer is safe and feasible. However, its long-term outcomes needs further investigation.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Xu Jianmin, Colorectal Surgery Department, Zhongshan Hospital, Fudan University.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3425 - Feasibility and impact of prospective DPYD screening in the Irish population
Presenter: Mohammed Zameer
Session: Poster Display session 2
Resources:
Abstract
1972 - Diet-derived metabolites and the risk of colorectal cancer: a nested case-control study in a population-based cohort, the Singapore Chinese Health Study
Presenter: Dawn Chong
Session: Poster Display session 2
Resources:
Abstract
4103 - Loss of subcutaneous adipose tissue during chemotherapy predicts reduced survival in patients with incurable colorectal cancer undergoing palliative therapy
Presenter: Erin Stella Sullivan
Session: Poster Display session 2
Resources:
Abstract
4309 - Obese and overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab.
Presenter: Bozena Cybulska-Stopa
Session: Poster Display session 2
Resources:
Abstract
3554 - Patient characteristics associated with poor performance status, ECOG 2-3, and effect on survival in 1086 Finnish metastatic colorectal cancers (mCRC) nationwide (prospective RAXO study)
Presenter: Pia Österlund
Session: Poster Display session 2
Resources:
Abstract
4572 - Discovery and Diagnosis of Metastatic Colorectal Cancer (mCRC) in the Real World: Final Results from a European Survey
Presenter: Iga Rawicka
Session: Poster Display session 2
Resources:
Abstract
4783 - Adherence to recommended intake of calcium and colorectal cancer risk in the HEXA study
Presenter: Jeeyoo Lee
Session: Poster Display session 2
Resources:
Abstract
5106 - Body size, sex and sidedness of incident colorectal cancer in a prospective Swedish cohort study
Presenter: Christina Siesing
Session: Poster Display session 2
Resources:
Abstract
3364 - Middle East & North Africa Registry to characterize RAS mutation status and tumor specifications in recently diagnosed patients with metastatic colorectal cancer (MORE-RAS Study)
Presenter: Mohamed Oukkal
Session: Poster Display session 2
Resources:
Abstract
3668 - Patient Demographics and Management Landscape of Metastatic Colorectal Cancer in the Third Line Setting: real-world data in an Australian Population
Presenter: Sandy Tun Min
Session: Poster Display session 2
Resources:
Abstract