Laparoscopic Left Hemicolectomy of Descending Colon Carcinoma with Superior Rectal Artery (SRA) Preservation and Natural Orifice Specimen Extraction (NOSE): A Standard Operating Procedure with a Video

Zhang K, Deng Z, Hu H, Yan J, Rui Y, Yi B and Zheng Y

Department of Gastrointestinal Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Cancer Hospital Affiliate to School of Medicine, China

^*Correspondance to: Yangchun Zheng 

 PDF  Full Text DOI: 10.25107/2474-1647.3664

Abstract

Background: Laparoscopy-assisted radical resection of colorectal cancer and Natural Orifice Specimen Extraction Surgery (NOSES) are widely used worldwide. However, due to the low incidence of descending colon cancer, some problems remain in the application of laparoscopic and NOSES techniques in left hemicolectomy. Herein, we introduce the technical procedure of laparoscopic left hemicolectomy with Superior Rectal Artery (SRA) preservation and NOSE. Methods: A retrospective analysis was performed on 39 patients who underwent laparoscopic left hemicolectomy with SRA preservation and NOSE in a single institution from November 2017 to May 2021. The patients’ general information, preoperative data and short-term postoperative results were analyzed. Results: All operations were completed smoothly, with an average operation duration of 227.17 ± 65.51 min, intraoperative bleeding of 91.05 ± 66.71 ml, time to ambulation of 11.97 ± 2.15 h, time to exhaust of 20.20 ± 10.08 h, time to liquid diet of 2.48 ± 0.72 days, and average postoperative stay of 7.66 ± 1.89 days. Two patients developed temporary intestinal obstruction, and one patient developed pulmonary infection. One patient developed a chyle fistula. One patient developed an intestinal infection. All of them recovered well after active supportive treatment and were discharged successfully. Conclusion: Laparoscopic left hemicolectomy with SRA preservation and NOSE is safe and feasible, can achieve satisfactory short-term results, and is worthy of further clinical investigation.

Keywords

Laparoscopic left hemicolectomy; Descending colon; Natural Orifice Specimen Extraction (NOSE); Superior rectal artery

Cite the article

Zhang K, Deng Z, Hu H, Yan J, Rui Y, Yi B, et al. Laparoscopic Left Hemicolectomy of Descending Colon Carcinoma with Superior Rectal Artery (SRA) Preservation and Natural Orifice Specimen Extraction (NOSE): A Standard Operating Procedure with a Video. Clin Surg. 2023; 8: 3664..