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© Annals of Laparoscopic and Endoscopic Surgery. All rights reserved.Background: Natural orifice surgery is used to minimize incision-related complications in colorectal surgery. Less pain, higher aesthetic score and higher patient comfort are aimed in this respect. Segmental colon resections were followed by total colon resections, but the process did not gain momentum like other resections. Methods: Review of the literatüre electronic searches of the PubMed/Medline and Google Scholar databases were carried out on 14 May 2022 using the key words (transvaginal OR transanal OR transrectal) AND ((colon OR colonic) AND (resection OR resections) OR colectomy) AND (total OR subtotal). Data for publication year, country, patient gender, age, surgical indication, natural orifice for extraction, duration of surgery, blood loss, type of ileo rectal anastomosis, morbidity, length of hospital stay, and follow-up time were recorded. Results: A total of 14 related and 71 patients were found in these studies. Publications which started in 2008, did not receive sufficient attention until 2018, it was later seen that there was an increase in the number of publications reported after 2018. Although benign diseases and early stage cancers constituted the patient population, it was observed that no significant gender differences were reported. In previous studies, it was reported that the transanal route (90%) was used predominantly and end-to-end anastomosis (59%) was the most preferred method. Although the complication rates were 20%, the necessity of reoperation was 6%. Conclusions: Although more objective results can be found with studies with large patient participation, the combination of total colectomy and natural orifice specimen extraction (NOSE) seems to be a technique that can increase patient comfort in suitable patients.

INTRODUCCION La extraccion de muestras de orificio natural (NOSE) para resecciones colorrectales, que mejoran aun mas las ventajas de la cirugia minimamente invasiva, se utilizan cada vez con mayor frecuencia. En este estudio, nuestro objetivo fue comparar los metodos de extraccion de muestras de nariz y transabdominales en casos de resecciones de colon derecho totalmente laparoscopicas. METODOS Se incluyeron datos de 52 pacientes que se sometieron a cirugia laparoscopica de colon derecho entre 2013 y 2019. La extraccion de muestras transabdominales se realizo en 35 pacientes, mientras que 17 pacientes fueron sometidos a NOSE. Se compararon datos demograficos, hallazgos operativos, resultados patologicos y datos de seguimiento. RESULTADOS Las mujeres (94% frente a 28%, p = 0,0001), comorbidas (76% frente a 40%, p = 0,01) y antecedentes de cirugia abdominal previa (75% frente a 23%, p = 0,001) fueron mas altas en el grupo NOSE . Todas las otras caracteristicas preoperatorias de los grupos fueron comparables. La perdida de sangre intraoperatoria, el tiempo de operacion y las tasas de complicaciones fueron similares en ambos grupos. La escala VAS postoperatoria (2.8 ± 1.2 vs. 4.5 ± 2.4, p = 0.001) y los puntajes cosmeticos fueron mejores en el grupo NOSE (10 vs. 7, p = 0.0001). Los resultados oncologicos fueron similares despues de un seguimiento medio de 27.4 ± 20.5 (1-77) meses. CONCLUSION El metodo NOSE despues de la reseccion laparoscopica del colon derecho fue un metodo mas ventajoso en terminos de cosmeticos y dolor postoperatorio que la extraccion de muestras transabdominales. INTRODUCTION Natural orifice specimen extraction (NOSE) for colorectal resections, which further enhance the advantages of minimally invasive surgery, are being used increasingly more often. In this study, we aimed to compare NOSE and transabdominal specimen extraction methods in cases of totally laparoscopic right colon resections. METHODs Data of 52 patients who underwent laparoscopic right colon surgery between 2013 and 2019 were included in the study. Transabdominal specimen removal was done in 35 patients, while 17 patients underwent NOSE. Demographic data, operative findings, pathological results, and follow-up data were compared. RESULTS Female (94% vs. 28%, p = 0.0001), co-morbid (76% vs. 40%, p = 0.01), and previous abdominal surgery history (75% vs. 23%, p = 0.001) were higher in the NOSE group. All the other pre-operative features of the groups were comparable. Intraoperative blood loss, operation time, and complication rates were similar in both groups. Post-operative visual analog scale (2.8 ± 1.2 vs. 4.5 ± 2.4, p = 0.001) and cosmetic scores were better in the NOSE group (10 vs. 7, p = 0.0001). Oncologic results were similar after a mean follow-up of 27.4 ± 20.5 (1-77) months. CONCLUSION The NOSE method following laparoscopic right colon resection was a more advantageous method in terms of cosmetics and post-operative pain than transabdominal specimen extraction.

Laparoscopic surgery for remnant gastric cancer has been reported in a limited number of cases, and data on post-operative complications are lacking. A 58-year-old male was admitted with remnant gastric cancer. He had undergone open subtotal gastrectomy 9 years ago for gastric cancer. Laparoscopic total gastrectomy was performed, and he was discharged on the 10th day uneventfully. The patient had complained of nausea and vomiting in the 2nd post-operative month. He clinically and radiologically diagnosed as ileus and required open emergency surgery. There was a transverse colon stenosis near the splenic flexure. Hartmann's procedure was done, and he was discharged on day 17. We have limited knowledge about colonic complications after laparoscopic gastric surgery. The development of stenosis in the transverse colon is one of these complications that should be kept in mind. As far as we know, such a complication has never been reported before.