Side-to-side and end to end Anastomoses comparable in NOSES Surgery for Left Colon Cancer: Study

The observation group was performed with side-to-side anastomosis (Overlap). For digestive tract reconstruction, the control group was anastomosed by end-to-end anastomosis; the intraoperative and postoperative conditions and complications were compared between the two groups.

Results: There was no significant difference in operation time and intraoperative blood loss between the two groups (P > 0.05). However, the intraoperative anastomosis time in the observation group was significantly shorter than that in the control group (P < 0.001). Additionally, there was no significant difference in the time of first exhaustion, defecation time, degree of patency of defecation, frequency of defecation, postoperative hospital stays and postoperative pain between the two groups (P > 0.05).

Furthermore, the overall incidence of postoperative complications did not show a significant difference (P > 0.05). In the NOSES surgery of left colon cancer, both side-to-side anastomosis (Overlap) and end-to-end anastomosis yielded comparable intraoperative and postoperative conditions and complications, but the side-to-side anastomosis (Overlap) method was simpler operation-wise and had a shorter intraoperative anastomosis time. As such, this method is the preferred anastomosis method when NOSES for colorectal cancer is carried out in primary hospitals.

Reference:

Huang, J., Wu, J., Fang, S. et al. Comparison of side-to-side anastomosis vs. end-to-end anastomosis in NOSES operation for left colon cancer: a retrospective study. BMC Surg 25, 142 (2025). https://doi.org/10.1186/s12893-025-02837-5