Design: Systematic Review and Meta-analysis

Setting: Research

Patients or Participants: Out of 1,236 identified studies, six met the inclusion criteria, comprising 372 patients. One study was a randomized controlled trial, and five were observational.

Interventions: Natural Orifice Specimen Extraction (NOSE) vs. Minilaparotomy and a subgroup analysis for Full Laparoscopic (L/S) NOSE vs. Minilaparotomy

Measurements and Main Results: Operation duration did not significantly differ between NOSE and minilaparotomy (MD: -10.85 min; 95% CI: [-23.33, 1.63]; p = .09). NOSE was associated with a significantly reduced length of hospital stay (MD: -0.76 day; 95% CI: [-1.21, -0.31]; p = .008). The major postoperative complication rates were 3.77% for NOSE and 5.55% for minilaparotomy, with no significant difference (OR: 0.84; 95% CI: [0.27, 2.60]; p = .76). Subgroup analysis revealed that Full L/S had significantly shorter operation duration (MD: -26.06 min; 95% CI: [-45.85, -6.27]; p = .01), reduced length of stay (MD: -0.75 day; 95% CI: [-1.25, -0.25]; p = .003), and lower blood loss (MD: -15.01 mL; 95% CI: [-29.64, -0.37]; p = .04)

Conclusion: NOSE emerged as a potentially safer alternative to minilaparotomy for tissue extraction in colectomy for bowel endometriosis. However, standardization of the procedure and additional randomized controlled trials are needed to validate these findings.