Prospective multicenter study of reduced port surgery combined with transvaginal specimen extraction for colorectal cancer resection

• Published in: Surgery today (Tokyo, Japan) Vol. 50; no. 7; pp. 734 - 742
• Main Authors: Takahashi, Hidekazu, Hamabe, Atsushi, Hata, Tsuyoshi, Nishizawa, Yuji, Nishimura, Atsushi, Itoh, Masaaki, Takemasa, Ichiro
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.07.2020
• Subjects: Medicine; Medicine & Public Health; Original Article; Surgery; Surgical Oncology; Laparoscopic surgery; Reduced port surgery; Prospective study; Colorectal cancer; Transvaginal specimen extraction
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-019-01946-y

Purpose The relevance of transvaginal specimen extraction (TVSE) combined with reduced port surgery (RPS) remains unknown. This study investigated the feasibility of TVSE with RPS according to short-term outcomes and cosmesis. Methods This prospective multicenter study enrolled ten patients at three institutions. For the semi-quantification of each parameter, we administered questionnaires to assess pain (visual analogue scale), subjective/objective wound healing esthetics [photo series questionnaires (PSQ)], and quality of life (QOL). Results No operative complications occurred, except one case of urinary tract infection, which was promptly cured with antibiotics. On day 0, pain was rated at 2.3 ± 0.67 at rest and 4.9 ± 0.82 during sneezing; these ratings gradually declined over time. The PSQ showed that the patient ratings of wound esthetics after TVSE were not inferior to ratings from patients after conventional laparoscopy or single incision laparoscopic surgery, and they were significantly higher than the patient ratings of wounds after laparotomy ( P  < 0.05). The QOL scores showed that, in comparison to before surgery, after surgery, patients reported significant deterioration of their physical function (96.67 ± 1.49 vs. 87.33 ± 2.71), emotional function (93.33 ± 2.72 vs. 86.67 ± 2.22), fatigue (7.78 ± 3.72 vs. 26.67 ± 8.31), and pain (6.67 ± 3.69 vs. 18.33 ± 4.61). Conclusion TVSE with RPS for colorectal cancer was feasible and was associated with a low degree of postoperative pain.