Abstract：
Natural orifice specimen extraction surgery (NOSES) is a new technique and uses natural orifice as the delivery route for specimen extraction to avoid supererogatory incision, and the safety and oncological outcomes of NOSES for right hemicolectomy are still inconclusive, so a meta-analysis was performed to compare these to conventional laparoscopic surgery (CLS). Related literature comparing NOSES with CLS for right hemicolectomy, whether randomized controlled trials (RCTs) or retrospective studies, were systematically searched. A random-effect model or fixed-effect model was used based on the I2 value. A total of six studies (all retrospective trials) involving 609 participants were included. Compared with CLS, NOSES was more preponderant than CLS in terms of surgical morbidity [odds ratio (OR) = 0.31; P = 0.0002], length of hospital stay [weighted mean difference (WMD) = - 1.52; P = 0.006], time to first flatus (WMD = - 0.82; P = 0.0008) and liquid intake (WMD = - 1.40; P < 0.00001), pain score of POD1 (WMD = - 1.99; P < 0.00001) and POD3 (WMD = - 1.15; P = 0.02), and cosmetic result (WMD = 1.84; P < 0.00001), while operative time of NOSES was prolonged (WMD = 18.29; P = 0.04). The number of dissected lymph nodes, recurrence, and 3-year overall survival (3-year OS) in NOSES group were comparable to the CLS group. Despite the lack of enough evidence, NOSES for right hemicolectomy has demonstrated comparable safety and oncological outcomes as CLS with less postoperative morbidity and pain, better cosmetic effect, and rapider recovery.
摘要：
自然孔口标本提取术（NOSES）是一种新技术，使用自然孔口作为标本提取的输送途径，以避免过度切口。并且右半结肠切除术的安全性和肿瘤学结果仍不确定，因此,我们进行了一项荟萃分析,将这些与传统腹腔镜手术(CLS)进行比较.相关文献比较NOSES与CLS用于右半结肠切除术，无论是随机对照试验（RCT）还是回顾性研究，有系统地搜索。基于I2值使用随机效应模型或固定效应模型。共纳入6项研究（所有回顾性试验），涉及609名参与者。与CLS相比,在手术发病率方面，鼻孔比CLS更占优势[比值比（OR）=0.31；P=0.0002]，住院时间[加权平均差（WMD）=-1.52；P=0.006]，首次排气时间（WMD=-0.82；P=0.0008）和液体摄入量（WMD=-1.40；P<0.00001），POD1（WMD=-1.99;P<0.00001）和POD3（WMD=-1.15;P=0.02）的疼痛评分，和美容结果(WMD=1.84；P<0.00001)，而手术时间延长（WMD=18.29；P=0.04）。淋巴结的解剖数量,复发,NOSES组的3年总生存期(3年OS)与CLS组相当.尽管缺乏足够的证据,与CLS相比，右半结肠切除术的NOSES具有相当的安全性和肿瘤学结果，术后发病率和疼痛较少。更好的美容效果，和快速恢复。
