A newer surgical technique called NOSES, which removes cancerous colon tissue through the rectum without abdominal cuts, speeds recovery compared to traditional surgery. According to Gram Research analysis of 126 patients, NOSES patients recovered bowel function about half a day faster, started eating sooner, and went home 1.7 days earlier while experiencing significantly less pain on the first day after surgery.
Researchers compared two ways surgeons remove cancerous tissue from the colon using minimally invasive techniques. One method, called NOSES, avoids making cuts in the abdominal wall by removing the specimen through the rectum instead. In a study of 126 patients, those who received NOSES recovered faster, experienced less pain, and went home sooner than patients who had a small abdominal incision. Both methods were equally safe and effective at treating cancer, but NOSES appears to offer real benefits for patient comfort and recovery time.
Key Statistics
A 2026 single-center study of 126 colorectal cancer patients found that NOSES (natural orifice specimen extraction surgery) reduced time to first bowel function to 2.3 days compared to 2.9 days with traditional minilaparotomy-assisted extraction.
Patients who underwent NOSES had an average hospital stay of 8.4 days versus 10.1 days for traditional surgery, a reduction of 1.7 days, according to a 2026 study of 126 colorectal cancer patients.
Pain scores on postoperative day 1 were significantly lower in NOSES patients (3.2 out of 10) compared to traditional surgery patients (4.5 out of 10) in a 2026 study of 126 colorectal cancer patients.
A 2026 study of 126 colorectal cancer patients showed NOSES patients could begin a liquid diet after 3.1 days on average, compared to 3.8 days for patients undergoing traditional minilaparotomy-assisted extraction.
The Quick Take
- What they studied: Whether a newer surgical technique that avoids abdominal cuts (NOSES) works as well as the traditional method with a small incision for removing cancerous colon tissue.
- Who participated: 126 patients with colorectal cancer who had minimally invasive surgery at one hospital. About 49 patients received the newer NOSES technique, and 77 received the traditional method with a small incision.
- Key finding: Patients who had NOSES recovered faster, with bowel function returning about half a day sooner and hospital stays about 1.7 days shorter. Pain levels on the first day after surgery were also noticeably lower in the NOSES group.
- What it means for you: If you need colon cancer surgery and are a good candidate, NOSES may offer faster recovery and less pain, though both methods are safe and effective. Talk with your surgeon about whether this option is right for your specific situation.
The Research Details
This was a retrospective study, meaning researchers looked back at medical records from patients who had already undergone surgery. They compared 49 patients who had NOSES (a technique where the cancerous tissue is removed through the rectum without cutting the abdominal wall) with 77 patients who had the traditional method (a small cut in the abdomen to remove the tissue). Both groups had minimally invasive laparoscopic surgery, which uses small cameras and instruments instead of large incisions.
The researchers measured several important outcomes including how quickly patients recovered bowel function, when they could eat again, how long they stayed in the hospital, their pain levels, and any complications that occurred. They also checked that the cancer was properly removed and staged in both groups to ensure the quality of cancer treatment was equal.
This type of study is useful for comparing real-world outcomes between two surgical approaches, though it cannot prove one method causes better results the way a randomized trial could. The researchers selected patients carefully for each group based on factors that might affect surgery success.
Understanding which surgical technique produces better patient outcomes helps surgeons choose the best approach for individual patients. Since both methods remove cancer effectively, differences in recovery speed and pain control become important factors in deciding which technique to use. This research provides practical information that can directly improve patient care.
This study has several strengths: it compared two similar groups of patients, measured multiple important outcomes, and looked at both safety and cancer treatment quality. However, because it was retrospective and not randomized, there may be differences between the groups that weren’t measured. The study was conducted at a single hospital, so results may not apply everywhere. The sample size of 126 patients is reasonable but not extremely large. Surgeons performing NOSES need special training, so results may depend on their experience level.
What the Results Show
The NOSES group recovered noticeably faster than the traditional surgery group across multiple measures. Patients in the NOSES group passed gas (first flatus) in an average of 2.3 days compared to 2.9 days in the traditional group, a difference that was statistically significant. They were able to start a liquid diet sooner, at 3.1 days versus 3.8 days. Most importantly, patients who had NOSES went home from the hospital after an average of 8.4 days, compared to 10.1 days for the traditional surgery group.
Pain control was significantly better in the NOSES group. On the first day after surgery, patients rated their pain as 3.2 out of 10 on average, compared to 4.5 out of 10 in the traditional group. This difference is clinically meaningful, suggesting patients experienced noticeably less discomfort.
Complications related to the surgical wound were reduced in the NOSES group since no abdominal incision was made. The researchers found no differences between groups in how well the cancer was removed or staged, meaning both techniques were equally effective at treating the cancer itself.
While the abstract does not provide detailed breakdowns of specific complication types, the reduction in wound-related complications in the NOSES group is significant because wound problems are a common source of patient discomfort and delayed recovery. The fact that gastrointestinal function recovered faster in the NOSES group suggests this technique may cause less trauma to the bowel and surrounding tissues.
NOSES is a relatively new technique, so direct comparisons with traditional methods are limited. This study adds to a growing body of evidence suggesting that avoiding abdominal wall incisions can improve recovery without sacrificing cancer treatment quality. Previous research on minimally invasive colorectal cancer surgery has shown benefits over open surgery, and this study extends those findings by comparing two minimally invasive approaches.
This was a single-center study at one hospital, so results may not apply to all surgical centers or surgeons. The study was retrospective, meaning researchers looked at past records rather than randomly assigning patients to each group, which could introduce bias. Surgeons performing NOSES need special training and experience, so the technique’s success may depend on surgeon skill level. The study did not report long-term outcomes beyond hospital discharge, so we don’t know if differences persist weeks or months later. Finally, the researchers selected patients carefully for each technique, so results may not apply to all colorectal cancer patients.
The Bottom Line
For patients with colorectal cancer who are good surgical candidates and have access to surgeons trained in NOSES, this technique appears to offer real benefits in pain control and recovery speed compared to traditional minilaparotomy-assisted extraction. The evidence is moderately strong for short-term recovery advantages. However, both methods are safe and effective at treating cancer, so the choice should be made in consultation with your surgical team based on your individual situation and your surgeon’s expertise.
This research is most relevant for patients with colorectal cancer who need minimally invasive surgery and have access to surgeons trained in NOSES. It’s also important for colorectal surgeons considering whether to adopt this newer technique. Patients should discuss with their surgical team whether they are candidates for NOSES based on tumor location, size, and other factors. Those with contraindications to transanal extraction should continue with traditional approaches.
Based on this study, patients who have NOSES can expect to pass gas and resume liquid diet intake about half a day to one day sooner than with traditional surgery. Hospital discharge typically occurs 1 to 2 days earlier. Pain relief is noticeable on the first postoperative day. Long-term outcomes beyond the hospital stay were not reported in this study, so expectations for full recovery should be discussed with your surgeon.
Frequently Asked Questions
What is NOSES surgery and how does it differ from regular colon cancer surgery?
NOSES removes cancerous tissue through the rectum without cutting the abdominal wall, while traditional surgery makes a small abdominal incision. Both use minimally invasive laparoscopic techniques with cameras and small instruments. NOSES avoids the additional wound, potentially reducing pain and speeding recovery.
How much faster do patients recover with NOSES compared to traditional surgery?
According to a 2026 study of 126 patients, NOSES patients went home 1.7 days sooner on average and recovered bowel function about half a day faster. They also experienced noticeably less pain on the first day after surgery, rating it 3.2 out of 10 versus 4.5 out of 10.
Is NOSES surgery as effective at treating colon cancer as traditional surgery?
Yes, a 2026 study found no differences between NOSES and traditional surgery in how well cancer was removed or staged. Both techniques were equally effective at treating the cancer itself while offering different recovery profiles.
Who is a good candidate for NOSES surgery?
The study indicates NOSES works best for highly selected patients, typically those with tumors in certain locations and sizes. Your surgeon will evaluate whether you’re a candidate based on tumor characteristics, your overall health, and their experience with the technique.
Are there any risks or complications specific to NOSES surgery?
NOSES eliminates abdominal wound complications since no incision is made there. The 2026 study found it was safe and feasible, though surgeons need special training. Discuss specific risks with your surgical team based on your individual situation.
Want to Apply This Research?
- Track daily pain levels on a 0-10 scale, time of first bowel function (gas and bowel movements), and dietary progression (clear liquids to soft foods to regular diet) to monitor your recovery trajectory against typical timelines.
- If you’re a candidate for NOSES, discuss this option with your colorectal surgeon and ask about their experience with the technique. Document your questions about recovery expectations, pain management, and return to normal activities to bring to your pre-surgery consultation.
- Use the app to log daily pain scores, bowel function milestones, dietary tolerance, and activity level for the first two weeks after surgery. Compare your recovery timeline to expected benchmarks and share this data with your surgical team at follow-up appointments to track your progress.
This article summarizes research findings and should not replace professional medical advice. NOSES is a specialized surgical technique that requires specific surgeon training and patient selection. If you have colorectal cancer or are considering any surgical procedure, consult with your healthcare provider or colorectal surgeon to discuss whether this technique is appropriate for your individual situation. Treatment decisions should be based on your specific medical condition, tumor characteristics, and your surgeon’s expertise and recommendations.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.