Zheng Liu, Zhexue Wang, Liu Yang, Zhiqiang Ma, Sheng Wang, Haitao Zhou, Lizhu Tang, Bo Wei, Shaojun Yu, Qiang Feng, Qingchao Tang, Ruiting Liu, Fei Wang, Guiyu Wang, Chaoxi Zhou, Wenbo Niu, Ye Wei, Xuejun Sun, Hongliang Yao, Jian Peng, Dan Ma, Junhong Hu, Yangchun Zheng, Bo Jiang, Fanghai Han, Zhiguo Xiong, Xianwei Mo, Taiyuan Li, Qingsi He, Zhongchen Liu, Yongxiang Li, Tiemin Zhang, Liang Kang, Zhenning Wang, Kefeng Ding, Wei Zhang, Petr Tsarkov, Inna Tulina, Ibatullin Artur, Sergey Efetov, William Tzu-Liang Chen, Mina Ming-Yin Shen, Cuneyt Kayaalp, Seon-Hahn Kim, Suk-Hwan Lee, Woo Yong Lee, Byung Soh Min, Sanghoo Kim, Jim Khan, Isaac Seow-En, Tran Xuan Hung, Ludovico Docimo, Atsushi Nishimura, Kay Uehara, Avanish Saklani, Ng Siu Man Simon, Meng Chia Shing William, Guanghui Luo, Amjad Parvaiz, Federico Maria Mongardini, Darcy Shaw, Audrius Dulskas, Armando Geraldo Franchini Melani, Antonello Forgione, Muhammad Naeem, Jin-Jiun Mah, Xishan Wang
This updated guideline provides a structured and practical reference for colorectal NOSES procedures, supporting wider adoption and continued surgical advancement.
PURPOSE: Natural orifice specimen extraction surgery (NOSES) has emerged as a minimally invasive technique in colorectal cancer treatment, offering improved postoperative recovery and cosmetic outcomes. Building upon previous editions, this third edition guideline aims to update and refine technical classifications, indications, and procedural standards based on the latest evidence and accumulated clinical experience.
METHODS: This guideline was jointly developed by the Colorectal Cancer Committee of the China Anti-Cancer Association and the International Alliance of NOSES, incorporating recent multicenter data, consensus discussions, and advancements in laparoscopic and robotic techniques. This updated guideline was developed through an expert consensus-based revision process informed by comprehensive literature review and available multicenter clinical evidence, and was finalized after iterative discussion and approval by the guideline steering committee.
RESULTS: This edition provides targeted updates from the previous version, including refined recommendations on preoperative assessment and acknowledgment of robotic assistance. Adjustments to surgical classifications, indications, and procedural descriptions have also been made to enhance clarity and clinical applicability.
CONCLUSION: This updated guideline provides a structured and practical reference for colorectal NOSES procedures, supporting wider adoption and continued surgical advancement.