Rectal Cancer, Surgery
Conditions
Keywords
Rectal Cancer, Natural Orifice Specimen Extraction, Propensity score matched
Brief summary
This study aims to compare the postoperative outcomes of low rectal cancer patients who underwent surgery with Natural Orifice Specimen Extraction (NOSE) versus traditional Pfannenstiel extraction.
Detailed description
Natural Orifice Specimen Extraction (NOSE) in colorectal surgery allows the extraction of the surgical specimen through the anal orifice. Several studies demonstrated improved postoperative pain, bowel movements, patient-reported cosmetic satisfaction, and psychological wellbeing after NOSE compared with traditional Pfannenstiel extraction. However, most of these studies focused on colon surgery. The aim of this retrospective propensity score matched study is to investigate the postoperative outcomes of NOSE in low rectal cancer surgery, classified according to the English National Low Rectal Cancer Development Programme (LOREC).
Interventions
PROCEDURENatural Orifice Specimen Extraction (NOSE)
Low rectal cancer resection with Total Mesorectal Excision (TME) and Natural Orifice Specimen Extraction (NOSE)
PROCEDURETraditional specimen extraction
Low rectal cancer resection with Total Mesorectal Excision (TME) and specimen extraction through Pfannenstiel incision
Sponsors
Istituto Clinico Humanitas
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients undergoing low anterior resection with Total Mesorectal Excision (TME) for low rectal cancer between January 2017 and January 2023 * Patients with rectal cancer classified as low according to the English National Low Rectal Cancer Development Programme (LOREC)
Exclusion criteria
* Patients undergoing non-restorative procedures * Patients undergoing immediate or delayed handsewn coloanal anastomosis * Patients undergoing planned open surgery or unplanned conversion from minimally invasive to open surgery * Patients with a concomitant diagnosis of Inflammatory Bowel Disease (IBD)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Surgical Site Infections (SSI) | 30 days after surgery | Rate difference of 30-day Surgical Site Infections (SSI)- defined according to the definition of the Center for Disease Control and Prevention (CDC) \[Ref\]- between the study cohorts. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Opioid rescue | From the date of surgery to the date of discharge | Difference in the proportion of patients requiring opioid rescue during the hospitalization |
| Postoperative pain | 72 hours after surgery | The median difference of 72-hour patient-reported pain- measured on the Visual Rating Scale (VRS) |
| Postoperative ileus | 30 days after surgery | Rate difference of 30-day postoperative functional ileus (define as the absence of bowel function for at least three days) |
| Incisional hernia | 6 months after surgery | The rate difference of six-month incisional hernia |
| Overall postoperative complications | 30 days after surgery | The rate difference of overall 30-day postoperative complications, classified according to the Clavien-Dindo scale \[ranging from 0 (no complications) to 5 (complications leading to death)\] |
Countries
Italy
Contacts
Primary ContactAnnalisa Maroli, PhD
Backup ContactStefano De Zanet, MS
Outcome results
None listed