Analysis Of The Impact Of The Previous Abdominal Surgery On The Robotic NOSES Surgery For Rectal Cancer

objective:To explore the short-term clinical efficacy and safety of the previous abdominal surgery(PAS)on Robotic natural orifice specimen extraction surgery Surgery(NOSES)for Rectal Cancer.Methods:A retrospective analysis of the clinical data of 366 patients who perform Robotic NOSES for Rectal Cancer from January 2016 to December 2020.All patients were divided into two groups: 73 patients PAS group and 293 patients without previous abdominal surgery(NPAS).All patients in both groups perform Robotic NOSES Surgery for Rectal Cancer.The PAS group was further divided into 4 categories according to the type of previous abdominal surgery,large PAS group,GPAS group,tsmall PAS group,UPAS group,operation time and conversion rate were compared with NPAS respectively.According to the type of previous abdominal surgery,it was further divided into the previous upper abdominal surgery,the previous lower abdominal surgery and the previous pelvic surgery.The operation time and conversion rate were compared with NPAS respectively.Results:Among the 73 patients in the PAS group,29(39,72%)were male and 44(60.27%)were female.Among the 293 patients in the non-PAS group,186(63.48%)were male and 107(36.51%)were female.Statistical difference(P<0.01).There were no significant differences in age,BMI,ASA score,tumor stage,etc.between the two groups(all P>0.05).There were no significant differences in operation time,conversion rate to laparotomy,intraoperative bleeding,dissection of lymph nodes,time of first meal after operation,length of postoperative hospital stay and postoperative complications between the two groups(all P>0.05).In the comparison of patients with different types of abdominal surgery history and NPAS patients,the mean operation time in the major PAS group was higher than that in the other groups,but there was no statistical difference.However,there was no significant difference in the average operation time and conversion rate to laparotomy between the major PAS group,the minor PAS group,the GPAS group,the UPAS group and the NPAS group.There was no statistically significant difference in the average operation time and conversion rate to laparotomy between previous upper abdominal,lower abdominal and pelvic surgery and NPAS.Conclusion:PAS has no negative impact on short-term outcomes of robotic NOSES for rectal cancer.Therefore,robotic NOSES for rectal cancer is safe and feasible for patients with PAS.