{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T02:10:58Z","timestamp":1755828658489,"version":"3.44.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Natural orifice specimen extraction surgery (NOSES) is widely used for colorectal cancer. However, there is limited study regarding the outcomes of patients with high BMI who undergo NOSES surgery for colorectal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 251 patients (including 205 Non-High BMI and 46 High BMI patients) who underwent NOSES for colorectal cancer between January 2013 and December 2018. Outcomes related to surgery, anal function and long-term survisval were compared between the Non-High BMI and High BMI patients with the propensity-score matching (PSM) method. Age, gender, tumor location (sigmoid\/rectum), preoperative CEA, CA199, T stage and N stage were considered as covariates for PSM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After matching, 44 patients in the Non-High BMI group and 44 patients in the High BMI group were eligible for analysis. No significant differences were observed between the groups in terms of operative time, blood loss, time to first flatus, time to first diet, postoperative hospital stays, positive margin, postoperative complication, conversion to open surgery and pathological outcomes (all <jats:italic>P<\/jats:italic>-value\u2009&amp;gt;\u20090.05). Besides, there was no significant difference for anal function 6 months after surgery between the two groups (<jats:italic>P<\/jats:italic>\u2009=\u20090.723). The overall survival (OS) and disease-free survival (DFS) for the Non-high BMI group were comparable to those for the High BMI group (<jats:italic>P<\/jats:italic>\u2009=\u20090.156 for OS, <jats:italic>P<\/jats:italic>\u2009=\u20090.266 for DFS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>With careful preoperative evaluation, High-BMI patients can successfully undergo NOSES surgery and achieve favorable outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1624266","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T14:32:03Z","timestamp":1755786723000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of high BMI colorectal cancer patients with natural orifice specimen extraction surgery: a propensity-score matching study"],"prefix":"10.3389","volume":"12","author":[{"given":"Chenkai","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenyang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Songtao","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haonan","family":"Qi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunlin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibatullin","family":"Artur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guiyu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"145","DOI":"10.3322\/caac.21601","article-title":"Colorectal cancer statistics, 2020","volume":"70","author":"Siegel","year":"2020","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1007\/BF01655705","article-title":"Laparoscopic colonic procedures","volume":"17","author":"Franklin","year":"1993","journal-title":"World J Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1002\/bjs.9757","article-title":"Randomized clinical trial of laparoscopic colectomy with or without natural-orifice specimen extraction","volume":"102","author":"Wolthuis","year":"2015","journal-title":"Br J Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.ijsu.2019.07.025","article-title":"Short-term efficacy of transvaginal specimen extraction for right colon cancer based on propensity score matching: a retrospective cohort study","volume":"72","author":"Li","year":"2019","journal-title":"Int J Surg Lond Engl"},{"key":"B5","doi-asserted-by":"publisher","first-page":"106787","DOI":"10.1016\/j.ijsu.2022.106787","article-title":"Surgical outcomes and sexual function after laparoscopic colon cancer surgery with transvaginal versus conventional specimen extraction: a retrospective propensity score matched cohort study","volume":"104","author":"Zhang","year":"2022","journal-title":"Int J Surg Lond Engl"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1007\/s00384-015-2280-0","article-title":"Influence of BMI on short-term surgical outcome after colorectal cancer surgery: a study based on the Swedish national quality registry","volume":"30","author":"Hede","year":"2015","journal-title":"Int J Colorectal Dis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1007\/s12029-021-00612-2","article-title":"Impact of BMI on adverse events after laparoscopic and open surgery for rectal cancer","volume":"53","author":"Hirpara","year":"2022","journal-title":"J Gastrointest Cancer"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"von Elm","year":"2007","journal-title":"Lancet Lond Engl"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1554","DOI":"10.1007\/s11605-012-1928-0","article-title":"Is laparoscopic colorectal cancer surgery in obese patients associated with an increased risk? 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