eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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3/2017
vol. 12
 
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abstract:
Case report

Two cases of laparoscopic total colectomy with natural orifice specimen extraction and review of the literature

Ersin Gundogan
,
Aydin Aktas
,
Cuneyt Kayaalp
,
Fatih Gonultas
,
Fatih Sumer

Videosurgery Miniinv 2017; 12 (3): 291–296
Online publish date: 2017/07/27
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We present two cases of natural orifice specimen extraction (NOSE) after laparoscopic total colectomy and ileorectal anastomosis (TC-IRA), and we also review all of the previously reported cases. Our aim was to focus on patient selection for NOSE after TC-IRA. The PubMed and Google Scholar databases were scanned. Demographic features, surgical indications, and techniques were analyzed. Basic calculations were used for statistical analysis. A total of 13 cases were detected in addition to our 2 cases. All of the specimens were removed through the natural orifices successfully. No case required a diverting ileostomy. No patients were converted to open surgery or to conventional laparoscopy. Complications were reported in three patients. Transanal extractions were performed in 12 cases (10 colonic inertia, 2 polyposis), and transvaginal extractions were performed in 3 cases (2 malignancy, 1 colonic inertia). Both transanal and transvaginal specimen extractions after laparoscopic TC-IRA can be preferred. However, transanal extraction seems to be feasible in cases of TC for benign disease with a limited mesenteric-omental resection. If the indication is a malignancy requiring a mesenteric-omental resection, a transvaginal route should be preferred for a voluminous specimen.
keywords:

natural orifice surgery, slow transit constipation, colorectal cancer, laparoscopic colorectal surgery, review, transrectal

  
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