To explore the influencing factors of the prognosis of patients with left-sided colon cancer treated by laparoscopic natural orifice transmural specimen extraction surgery (NOSES).

The clinical data of 113 patients with left-sided colon cancer who underwent laparoscopic NOSES treatment from October 2021 to October 2024 were retrospectively analyzed. The patients were divided into the poor prognosis group (n=33) and the good prognosis group (n=80) based on the postoperative follow-up results. Multivariate Logistic regression analysis was used to identify the independent factors related to the prognosis of patients after laparoscopic NOSES treatment.

The poor prognosis group had a lower degree of differentiation, TNM stage of Ⅲ~Ⅳ, lymph node metastasis, vascular invasion, nerve invasion, and no postoperative adjuvant chemotherapy, which were all higher than those in the good prognosis group (P<0.05). After multivariate Logistic regression analysis, tumor differentiation degree of low differentiation (OR=4.983, 95%CI: 1.510~16.440), lymph node metastasis (OR=5.051, 95%CI: 1.332~19.157), vascular invasion (OR=5.396, 95%CI: 1.456~20.000), and nerve invasion (OR=6.048, 95%CI: 1.849~19.782) were all independent risk factors for poor prognosis in patients with left-sided colon cancer after laparoscopic NOSES treatment.

The prognosis of left-sided colon cancer patients treated by laparoscopic NOSES is influenced by multiple factors. Patients with low tumor differentiation, lymph node metastasis, vascular invasion, and nerve invasion have a worse prognosis. Clinicians need to formulate individualized intervention plans, strengthen perioperative management and postoperative follow-up, and standardize postoperative adjuvant therapy to improve the prognosis of patients.