Transvaginal natural orifice transluminal endoscopic surgery-assisted versus transumbilical laparoendoscopic single-site ovarian cystectomy for ovarian mature cystic teratoma. A randomized controlled trial.

Ginekologia polska Pub Date : 2024-01-01 Epub Date: 2023-12-15 DOI:10.5603/gpl.95422
Yulin Zhang, Ying Jia, Xuelin Dai, Fulan Wang, Yao Gong
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Abstract

Objectives: Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and transumbilical laparoendoscopic single-site surgery (LESS) have shown the prospection as minimally invasive procedures. Here we aimed to compare ovarian cystectomy assisted by vNOTES and by LESS for ovarian mature cystic teratoma (OMCT).

Material and methods: A total of 81 premenopausal women with OMCT were randomized to undergo ovarian cystectomy assisted by either vNOTES (n = 41) or LESS (n = 40). The main outcome was the operative time. Secondary outcomes included the length of hospital stay, visual analog scale (VAS) pain scores, abdominal contamination by teratoma contents, and intraoperative and postoperative complications.

Results: There were no intergroup differences in age, body mass index, tumor size, or bilaterality of tumor. The operative time for the vNOTES group was significantly shorter than that for the LESS group (68.41 ± 20.92 min vs 85.05 ± 32.94 min, p = 0.008). The highest VAS pain score 24 hours postoperatively was 1.21 ± 0.48 in the vNOTES group and 2.43 ± 0.57 in the LESS group (p < 0.001). Twenty-four of the 40 patients in the LESS group experienced teratoma rupture intraoperatively, leading to abdominal contamination by the teratoma content, while 5 abdominal contamination was observed in the vNOTES group (p = 0.005. No significant differences between the two groups were observed in the other outcomes.

Conclusions: vNOTES assisted ovarian cystectomy has short operative time, fast recovery, no scarring, less pain, and low rate of abdominal contamination. Consequently, vNOTES might be superior to LESS for treating OMCTs.

经阴道自然孔腔内镜手术辅助与经脐带腹腔镜单部位卵巢囊肿切除术。随机对照试验。
目的:经阴道自然孔腔内镜手术(vNOTES)和经脐腹腔内镜单部位手术(LESS)作为微创手术具有广阔的前景。在此,我们旨在比较卵巢成熟囊性畸胎瘤(OMCT)的vNOTES和LESS辅助卵巢囊肿切除术:81名患有卵巢成熟囊性畸胎瘤的绝经前妇女被随机分配接受vNOTES(41人)或LESS(40人)辅助的卵巢囊肿切除术。主要结果是手术时间。次要结果包括住院时间、视觉模拟量表(VAS)疼痛评分、畸胎瘤内容物对腹腔的污染以及术中和术后并发症:结果:各组间在年龄、体重指数、肿瘤大小或双侧肿瘤方面均无差异。vNOTES组的手术时间明显短于LESS组(68.41 ± 20.92 min vs 85.05 ± 32.94 min,P = 0.008)。术后 24 小时 VAS 疼痛评分的最高值为 vNOTES 组(1.21 ± 0.48)和 LESS 组(2.43 ± 0.57)(p < 0.001)。LESS组的40名患者中有24名在术中发生畸胎瘤破裂,导致腹腔被畸胎瘤内容物污染,而vNOTES组有5名患者腹腔被污染(p = 0.005)。结论:vNOTES辅助卵巢囊肿切除术具有手术时间短、恢复快、无瘢痕、疼痛轻、腹腔污染率低等优点。结论:vNOTES辅助卵巢囊肿切除术手术时间短、恢复快、无疤痕、疼痛轻、腹腔污染率低,因此在治疗卵巢囊肿方面,vNOTES可能优于LESS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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