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


Gundogan E. , AKTAŞ A., KAYAALP C. , Gonultas F., SÜMER F.

VIDEOSURGERY AND OTHER MINIINVASIVE TECHNIQUES, cilt.12, ss.291-296, 2017 (SCI İndekslerine Giren Dergi) identifier identifier identifier

  • Cilt numarası: 12 Konu: 3
  • Basım Tarihi: 2017
  • Doi Numarası: 10.5114/wiitm.2017.69227
  • Dergi Adı: VIDEOSURGERY AND OTHER MINIINVASIVE TECHNIQUES
  • Sayfa Sayıları: ss.291-296

Özet

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.