To investigate success rate and influential factors of laparoscopic colorectal resections (LCRs) followed by natural orifice specimen extraction (NOSE) in patients with rectal cancer.

From April 2016 to April 2018, retrospective analysis were performed in 76 patients with rectal cancer who received LCRs+ NOSE. We prefer to anal approach firstly, however if it fails, vaginal approach would be tried. If both approaches fail, the patient would be judged to be unsuitable for NOSE, then specimen would be removed through abdominal incision. Surgical indications, location of excision, procedure, incision site, method of aspiration, specimen size, and NOSE failure were recorded. Statistical analysis were performed by using SPSS18.0 software was used for statistical analysis of the data, and the chi-square test of the success and failure cases of NOSE was used to analyze the data. The size of specimens was examined by t-test. P<0.05 was statistically significant.

7 cases of conversions to open abdominal incision occurred during operation. 51 (73.9%) patients, including 48(94.1%) cases of anal approach and 3 (5.9%) cases of vagina approach, received successful NOSE after LCRs, while 18 (26.1%) cases failed A lower success rate of NOSE occurred mainly in male patients with severe colon lesions and large tumor size. The mean size of removed specimens was (3.6±3.2) and (5.6±1.5) cm by using anal approach and vaginal approach respectively, and the mean tumor size of the failed cases was (6.6±4.4) cm (P<0.05).

Better prognosis could be achieved in patients with rectal cancer underwent laparoscopic resection + NOSE, while higher success rate could be achieved when milder lesions or in female patients.