{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:07:31Z","timestamp":1789020451422,"version":"build-2803163510"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Redundant colon is one of the anatomical causes of slow transit constipation (STC). When conservative management fails, surgical intervention with subtotal colectomy is indicated. This study aimed to compare the perioperative outcomes of laparoscopy-assisted natural orifice specimen extraction (LA-NOSE) subtotal colectomy with conventional laparoscopy-assisted subtotal colectomy for redundant colon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 34 patients with redundant colon who underwent laparoscopy-assisted subtotal colectomy with cecorectal anastomosis at the Affiliated Hospital of Chengdu University between January 2009 and January 2026. Of these, 16 patients underwent LA-NOSE and 18 underwent conventional surgery with a mini-laparotomy for specimen extraction. Categorical perioperative outcomes were compared using Fisher's exact test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable between the two groups. The LA-NOSE group showed certain advantages in postoperative recovery: sitting up within 24\u2005h (87.5% vs. 38.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), getting out of bed within 2 days (93.8% vs. 55.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019), ambulation within 3 days (100% vs. 72.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046), return of gastrointestinal function within 2 days (62.5% vs. 27.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045), liquid diet tolerance within 3 days (87.5% vs. 44.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), and earlier suture removal on days 6\u20137 (100% vs. 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The incidence of surgical site infection (SSI) was significantly lower in the LA-NOSE group (0% vs. 27.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046). Operative time, estimated blood loss, and the incidence of intestinal obstruction, anastomotic leakage, and intra-abdominal infection showed no significant differences between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LA-NOSE subtotal colectomy is a safe and feasible minimally invasive option for redundant colon, offering accelerated postoperative recovery, reduced SSI, and superior cosmetic outcomes without compromising safety. This technique adheres to the principles of Enhanced Recovery After Surgery (ERAS) and offers an alternative treatment option for transnatural orifice specimen extraction in benign colonic diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1926480","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:33:36Z","timestamp":1789018416000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic-assisted natural orifice specimen extraction subtotal colectomy for redundant colon: a retrospective parallel-cohort comparative study with reduced surgical site infections and accelerated recovery"],"prefix":"10.3389","volume":"13","author":[{"given":"Wen-Na","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Sichuan Provincial People\u2019s Hospital, School of Medicine, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Hao","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Hernia and Abdominal Wall Surgery, Affiliated Hospital of Chengdu University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1159\/000540912","article-title":"Evidence-based clinical guidelines for chronic constipation 2023","volume":"106","author":"Ihara","year":"2025","journal-title":"Digestion"},{"key":"B2","doi-asserted-by":"publisher","first-page":"108","DOI":"10.3390\/medicina60010108","article-title":"Idiopathic slow transit constipation: pathophysiology, diagnosis, and management","volume":"60","author":"Vlismas","year":"2024","journal-title":"Medicina (Kaunas)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1046\/j.1365-2982.2000.00198.x","article-title":"Slow transit constipation: a model of human gut dysmotility. Review of possible aetiologies","volume":"12","author":"Knowles","year":"2000","journal-title":"Neurogastroenterol Motil"},{"key":"B4","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1016\/j.bpg.2007.07.001","article-title":"Constipation","volume":"21","author":"Bharucha","year":"2007","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"8244","DOI":"10.1038\/s41598-025-92783-2","article-title":"Poly-\u03b3-glutamic acid alleviates slow transit constipation by regulating aquaporin and gut microbes","volume":"15","author":"Wang","year":"2025","journal-title":"Sci Rep"},{"key":"B6","doi-asserted-by":"publisher","first-page":"6","DOI":"10.4240\/wjgs.v10.i2.6","article-title":"Dolichocolon revisited: an inborn anatomic variant with redundancies causing constipation and volvulus","volume":"10","author":"Raahave","year":"2018","journal-title":"World J Gastrointest Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1002\/jpn3.70291","article-title":"Dolichocolon is common in pediatric gastroenterology patients with constipation and associated complaints","volume":"82","author":"Simon","year":"2026","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2327","DOI":"10.1016\/j.cgh.2024.04.009","article-title":"Colon volume by computed tomography and scintigraphic colonic transit in constipated patients with or without redundant colon","volume":"22","author":"Dilmaghani","year":"2024","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1007\/s00104-021-01399-5","article-title":"Slow transit constipation","volume":"93","author":"Sailer","year":"2022","journal-title":"Chirurg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1111\/j.1445-2197.2007.04051.x","article-title":"Slow-transit constipation: evaluation and treatment","volume":"77","author":"Wong","year":"2007","journal-title":"ANZ J Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1016\/j.anchir.2004.07.003","article-title":"Surgical management for slow-transit constipation","volume":"129","author":"Alves","year":"2004","journal-title":"Ann Chir"},{"key":"B12","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/BF02048263","article-title":"Results of colectomy for severe slow transit constipation","volume":"39","author":"Lubowski","year":"1996","journal-title":"Dis Colon Rectum"},{"key":"B13","doi-asserted-by":"publisher","first-page":"S164","DOI":"10.1016\/j.ijsu.2014.08.357","article-title":"Incisional hernia in the elderly: risk factors and clinical considerations","volume":"12","author":"Cagli\u00e0","year":"2014","journal-title":"Int J Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1016\/S2468-1253(20)30075-3","article-title":"Preoperative oral antibiotics and surgical-site infections in colon surgery (ORALEV): a multicentre, single-blind, pragmatic, randomised controlled trial","volume":"5","author":"Espin Basany","year":"2020","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1007\/s10151-010-0593-0","article-title":"Local application of gentamicin collagen implants in the prophylaxis of surgical site infections following gastrointestinal surgery: a review of clinical experience","volume":"14","author":"De Bruin","year":"2010","journal-title":"Tech Coloproctol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e70131","DOI":"10.1111\/wrr.70131","article-title":"Incisional hernia development: wound healing gone wrong?","volume":"34","author":"Abbas","year":"2026","journal-title":"Wound Repair Regen"},{"key":"B17","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/s10029-022-02676-w","article-title":"Diastasis recti is associated with incisional hernia after midline abdominal surgery","volume":"27","author":"Booth","year":"2023","journal-title":"Hernia"},{"key":"B18","doi-asserted-by":"publisher","first-page":"265","DOI":"10.2147\/CEG.S135331","article-title":"Natural orifice specimen extraction in colorectal surgery: patient selection and perspectives","volume":"11","author":"Izquierdo","year":"2018","journal-title":"Clin Exp Gastroenterol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1586\/14737175.7.5.533","article-title":"Highlights in postoperative pain treatment","volume":"7","author":"Leykin","year":"2007","journal-title":"Expert Rev Neurother"},{"key":"B20","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1007\/s13304-022-01412-4","article-title":"Total 102 natural orifice specimen extraction following laparoscopic colorectal resections","volume":"75","author":"Gundogan","year":"2023","journal-title":"Updates Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1089\/lap.2025.0003","article-title":"Natural orifice extraction techniques (natural orifice specimen extraction and natural orifice transluminal endoscopic surgery) for left-sided colorectal cancer: a systematic review and meta-analysis of randomized controlled trials","volume":"35","author":"Pompeu","year":"2025","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"B22","doi-asserted-by":"publisher","first-page":"2973","DOI":"10.1097\/JS9.0000000000002285","article-title":"Development and prospects of natural orifice specimen extraction surgery for colorectal cancer: a review article","volume":"111","author":"Huang","year":"2025","journal-title":"Int J Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"357","DOI":"10.3760\/cma.j.cn441530-20221119-00476","article-title":"Specimen extraction through natural orifices with Cai tubes in gastrointestinal surgery: a single-institute series of 234 cases","volume":"26","author":"Zhuang","year":"2023","journal-title":"Zhonghua Wei Chang Wai Ke Za Zhi"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1839442","DOI":"10.3389\/fmed.2026.1839442","article-title":"Laparoscopic-assisted subtotal colectomy cecal-rectal anastomosis for redundant colon-associated slow-transit constipation: a single-center retrospective case series with long-term follow-up","volume":"13","author":"Liu","year":"2026","journal-title":"Front Med (Lausanne)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1262","DOI":"10.1053\/j.gastro.2016.02.032","article-title":"Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV","volume":"150","author":"Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"B26","doi-asserted-by":"publisher","first-page":"109397","DOI":"10.1016\/j.surg.2025.109397","article-title":"Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS) society recommendations 2025","volume":"184","author":"Gustafsson","year":"2025","journal-title":"Surgery"},{"key":"B27","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1093\/gastro\/goy055","article-title":"International consensus on natural orifice specimen extraction surgery (NOSES) for colorectal cancer","volume":"7","author":"Guan","year":"2019","journal-title":"Gastroenterol Rep (Oxf)"},{"key":"B28","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s44178-023-00034-z","article-title":"International guideline on natural orifice specimen extraction surgery (NOSES) for colorectal cancer (2023 version)","volume":"2","author":"Liu","year":"2023","journal-title":"Holistic Integrative Oncology"},{"key":"B29","doi-asserted-by":"publisher","first-page":"104","DOI":"10.4103\/iju.iju_304_24","article-title":"Transvaginal natural orifice specimen extraction surgery in simple nephrectomy","volume":"41","author":"Kudunthail","year":"2025","journal-title":"Indian J Urol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.ijsu.2020.07.043","article-title":"Natural orifice specimen extraction surgery in laparoscopic pancreaticoduodenectomy: a single-center case series","volume":"82","author":"Zhang","year":"2020","journal-title":"Int J Surg"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e100162","DOI":"10.7759\/cureus.100162","article-title":"The role of natural orifice specimen extraction in modern surgery. A narrative review","volume":"17","author":"Salib","year":"2025","journal-title":". Cureus"},{"key":"B32","doi-asserted-by":"publisher","first-page":"2641","DOI":"10.2217\/fon-2023-0769","article-title":"Natural orifice specimen extraction surgery versus small-incision assisted laparoscopic radical right hemicolectomy","volume":"19","author":"Yu","year":"2023","journal-title":"Future Oncol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"201","DOI":"10.7602\/jmis.2020.23.4.201","article-title":"Natural orifice specimen extraction (NOSE) with single-stapling anastomosis for left colon cancer","volume":"23","author":"Shen","year":"2020","journal-title":"J Minim Invasive Surg"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.1007\/s00384-015-2337-0","article-title":"Laparoscopic resection with natural orifice specimen extraction versus conventional laparoscopy for colorectal disease: a meta-analysis","volume":"30","author":"Ma","year":"2015","journal-title":"Int J Colorectal Dis"},{"key":"B35","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.atc.2004.11.013","article-title":"Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain","volume":"23","author":"Joshi","year":"2005","journal-title":"Anesthesiol Clin North Am"},{"key":"B36","doi-asserted-by":"publisher","first-page":"526","DOI":"10.3393\/ac.2022.00458.0065","article-title":"Robotic natural orifice specimen extraction surgery (NOSES) for anterior resection","volume":"39","author":"Pham","year":"2023","journal-title":"Ann Coloproctol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/s11916-022-01009-x","article-title":"Enhanced recovery after surgery: opioid sparing strategies after discharge: a review","volume":"26","author":"Rajput","year":"2022","journal-title":"Curr Pain Headache Rep"},{"key":"B38","doi-asserted-by":"publisher","first-page":"121","DOI":"10.2217\/cer-2021-0258","article-title":"Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements","volume":"11","author":"Tazreean","year":"2022","journal-title":"J Comp Eff Res"},{"key":"B39","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1007\/s00595-020-01956-1","article-title":"The enhanced recovery after surgery (ERAS) protocol to promote recovery following esophageal cancer resection","volume":"50","author":"Ashok","year":"2020","journal-title":"Surg Today"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1092128","DOI":"10.3389\/fsurg.2023.1092128","article-title":"Comparison of transabdominal wall specimen retrieval and natural orifice specimen extraction robotic surgery in the outcome of colorectal cancer treatment","volume":"10","author":"Houqiong","year":"2023","journal-title":"Front Surg"},{"key":"B41","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1007\/s00464-020-08250-8","article-title":"Natural orifice versus conventional mini-laparotomy for specimen extraction after reduced-port laparoscopic surgery for colorectal cancer: propensity score-matched comparative study","volume":"36","author":"Chang","year":"2022","journal-title":"Surg Endosc"},{"key":"B42","doi-asserted-by":"publisher","first-page":"837902","DOI":"10.3389\/fendo.2022.837902","article-title":"Is natural orifice specimen extraction surgery really safe in radical surgery for colorectal cancer?","volume":"13","author":"Liu","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B43","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1111\/codi.15930","article-title":"Transrectal natural orifice specimen extraction in left hemicolectomy for tumours around the splenic flexure: old wine in new bottles","volume":"24","author":"Jong","year":"2022","journal-title":"Colorectal Dis"},{"key":"B44","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1016\/j.jss.2019.05.034","article-title":"A multicenter study evaluating natural orifice specimen extraction surgery for rectal cancer","volume":"243","author":"Liu","year":"2019","journal-title":"J Surg Res"},{"key":"B45","doi-asserted-by":"publisher","first-page":"106196","DOI":"10.1016\/j.ijsu.2021.106196","article-title":"The natural orifice specimen extraction surgery compared with conventional laparoscopy for colorectal cancer: a meta-analysis of efficacy and long-term oncological outcomes","volume":"97","author":"Wang","year":"2022","journal-title":"Int J Surg"},{"key":"B46","doi-asserted-by":"publisher","first-page":"12981","DOI":"10.3748\/wjg.v20.i36.12981","article-title":"Laparoscopic natural orifice specimen extraction-colectomy: a systematic review","volume":"20","author":"Wolthuis","year":"2014","journal-title":"World J Gastroenterol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1007\/s10151-017-1611-2","article-title":"Success rate of natural orifice specimen extraction after laparoscopic colorectal resections","volume":"21","author":"Karagul","year":"2017","journal-title":"Tech Coloproctol"},{"key":"B48","doi-asserted-by":"publisher","first-page":"e17279","DOI":"10.1111\/codi.17279","article-title":"Evaluation of the efficacy of natural orifice specimen extraction surgery versus conventional laparoscopic surgery for colorectal cancers: a systematic review and meta-analysis","volume":"27","author":"Cao","year":"2025","journal-title":"Colorectal Dis"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1926480\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:33:37Z","timestamp":1789018417000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1926480\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":48,"alternative-id":["10.3389\/fsurg.2026.1926480"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1926480","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"article-number":"1926480"}}