With the rapid development of minimally invasive surgery for the treatment of colorectal diseases, novel surgical techniques aiming at reducing surgical trauma have become frequently discussed issues. By avoiding auxiliary abdominal incision for specimen extraction, natural orifice specimen extraction surgery (NOSES), including transvaginal specimen extraction (TVSE) and transanal specimen extraction (TASE), is thought to be one of the least invasive options in the treatment of colorectal cancer (CRC). However, most previous studies concerning the safety and effectiveness of NOSES are single-centered with limited sample sizes. Whether previous findings can be generalized to a wider patient population remains unclear.