Our Summary

This research paper is about a type of surgery called Natural Orifice Specimen Extraction (NOSE). In NOSE, doctors remove parts of the body through natural openings like the anus, instead of making a big cut into the abdomen. This method has been shown to cause fewer problems after surgery and help patients heal faster.

The researchers in this study looked at the experiences of 27 patients who had part of their sigmoid colon (the last part of the large intestine) removed through NOSE. Most of these patients were women, and their average age was about 54. A lot of them were also overweight. They had this surgery because they had conditions like recurrent diverticulitis, rectal prolapse, perforated diverticulitis, colovesical fistula, and abdominal abscess.

The findings showed that these patients lost an average of 63.26 mL of blood during surgery, and they stayed in the hospital for about 3.6 days after. Only three of them had a fever after the surgery, but it went away the next day. One patient had to stay in the hospital for 19 days because they needed dialysis and rehab. Importantly, none of the patients had any complications like infection, hernias, wound opening, urinary tract infections, or leakage at the surgical site. Nobody died after the surgery.

So, this study shows that NOSE is a practical and safe way to do sigmoidectomies. It’s a good alternative to traditional surgery where doctors cut into the abdomen. This can be especially useful for treating non-cancerous diseases of the colon.

FAQs

  1. What is a Natural Orifice Specimen Extraction (NOSE) and how is it different from traditional surgery?
  2. What were the outcomes of the patients who had their sigmoid colon removed through NOSE?
  3. Is the NOSE method a safe and effective alternative for sigmoidectomies?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy through NOSE is to follow post-operative care instructions carefully to ensure a smooth recovery. This may include taking prescribed medications, eating a healthy diet, staying hydrated, avoiding strenuous activities, and attending follow-up appointments with your healthcare provider. It’s also important to listen to your body and report any unusual symptoms or concerns to your doctor promptly. By following these guidelines, you can help optimize your healing process and reduce the risk of complications.

Suitable For

Patients who are typically recommended for sigmoidectomy include those with conditions such as recurrent diverticulitis, rectal prolapse, perforated diverticulitis, colovesical fistula, and abdominal abscess. These patients may have symptoms like chronic abdominal pain, rectal bleeding, changes in bowel habits, and complications like perforation or infection of the colon. Additionally, patients who are overweight or obese may also benefit from sigmoidectomy to improve their overall health and quality of life.

Timeline

Before the sigmoidectomy:

  1. Patients were diagnosed with conditions like recurrent diverticulitis, rectal prolapse, perforated diverticulitis, colovesical fistula, and abdominal abscess.
  2. Patients underwent pre-operative evaluations and consultations with their doctors to discuss the surgery.
  3. Patients may have undergone pre-operative tests such as blood work, imaging studies, and bowel preparation to empty the colon.

After the sigmoidectomy:

  1. Patients lost an average of 63.26 mL of blood during surgery.
  2. Patients stayed in the hospital for about 3.6 days post-surgery.
  3. Only three patients had a fever after surgery, which resolved the next day.
  4. One patient had an extended hospital stay due to additional medical needs.
  5. None of the patients experienced complications such as infection, hernias, wound opening, urinary tract infections, or leakage at the surgical site.
  6. Patients recovered well and did not experience any post-operative mortality.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with sigmoidectomy through Natural Orifice Specimen Extraction (NOSE)?

  2. How long is the recovery period after sigmoidectomy through NOSE compared to traditional surgery methods?

  3. What kind of post-operative care and follow-up appointments will be needed after sigmoidectomy through NOSE?

  4. Will I need any special dietary restrictions or lifestyle changes after the surgery?

  5. How long will I need to stay in the hospital after the surgery?

  6. What are the long-term outcomes and success rates of sigmoidectomy through NOSE compared to traditional surgery methods?

  7. Are there any specific factors or conditions that make a patient a better candidate for sigmoidectomy through NOSE?

  8. How experienced is the surgical team in performing sigmoidectomies through NOSE?

  9. Will I need any additional procedures or treatments before or after the sigmoidectomy through NOSE?

  10. What are the alternatives to sigmoidectomy through NOSE, and why is this method recommended in my case?

Reference

Authors: Salim N, Daidone C, Smith L, Raza A. Journal: Cureus. 2023 Dec 4;15(12):e49902. doi: 10.7759/cureus.49902. eCollection 2023 Dec. PMID: 38174165