Abstract
Purpose There have been few reports that have focused on the combination of the laparoscopic approach and natural orifice specimen extraction (NOSE) surgery for complete rectal prolapse (CRP). The aim of this study was to compare the feasibility, safety and short-term clinical efficacy of NOSE surgery with those of conventional laparoscopic resection rectopexy in the treatment of CRP.Methods In a group of 45 patients selected between January 2019 and October 2023, 28 patients underwent conventional laparoscopic resection rectopexy (LRR), and 17 patients underwent transanal NOSE laparoscopic resection rectopexy (NOSE-LRR). Preoperative and postoperative clinical variables of the two groups of patients were compared and analyzed.Results The mean operation time was longer in the NOSE-LRR group than in the LRR group (150.29 min versus 134.18 min, p < 0.001). The NOSE-LRR group had less postoperative pain than did the LRR group (median VAS score of 4 versus 5 on the first day after surgery, p = 0.004; median VAS score of 2 versus 3 on the third day after surgery, p = 0.003). The median length of hospital stay was significantly shorter in the NOSE-LRR group (7 days versus 9 days, p < 0.001). A significant reduction in the incontinence score and constipation score was observed in both groups after surgery (p < 0.001). However, there was no significant difference in the postoperative constipation score or incontinence score between the two groups.Conclusion LRR combined with the NOSE technique leads to a shorter length of hospital stay and less postoperative pain in patients with CRP than in patients who undergo traditional LRR but with a longer operation time. The novel NOSE method is feasible and safe for use in patients with CRP.