Feasibility of vNOTES hysterectomy in patients with enlarged uteri: a single-center experience.

IF 1.4 Q3 OBSTETRICS & GYNECOLOGY
Candost Hanedan, Hande Nur Öncü, Neslihan Öztürk, Gökçen Ege, Oğuz Kaan Köksal, Vakkas Korkmaz
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Abstract

Objective: To evaluate the feasibility, safety, and surgical outcomes of vaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy in patients with enlarged uteri due to benign, premalignant, and malignant conditions.

Material and methods: Patients who underwent vNOTES hysterectomy at a tertiary gynecologic oncology center were included. Patients with large uteri (>280 g or equivalent to >12-week size) were included regardless of prior cesarean delivery, obesity, nulliparity, or the presence of premalignant or malignant pathology. Demographic data, surgical outcomes, and complication details were analyzed. Complications were classified as minor or major.

Results: The cohort consisted of 46 women with a median age of 54 (40-74) years, and median body mass index 31 (21-51) kg/m². A history of previous abdominal surgery was present in 58.7%, and 21.7% (10/46) had previously undergone cesarean section. The median operative time was 56 (35-95) minutes, and the median uterine weight was 410 (280-1036) grams. The overall conversion and complication rates were both 4.3% (n=2). No major complications were observed. Minor complications included intraoperative bleeding controlled without transfusion and postoperative vaginal bleeding managed conservatively. The median hospital stay was 30 (16-72) hours. All patients were discharged without requiring reoperation during the postoperative period.

Conclusion: vNOTES hysterectomy was a feasible and safe, minimally invasive approach for patients with enlarged uteri, including those with obesity, prior abdominal surgery, and premalignant or malignant indications. It provides favorable surgical outcomes with low complication and conversion rates. This study supports the use of the vNOTES technique with a broader adoption in patients with large uteri.

子宫增大患者行vNOTES子宫切除术的可行性:单中心经验。
目的:评价阴道自然口腔内内镜下子宫切除术(vNOTES)治疗良性、癌前和恶性子宫肿大患者的可行性、安全性和手术效果。材料和方法:纳入在三级妇科肿瘤中心行vNOTES子宫切除术的患者。大子宫(>280 g或相当于>12周大小)的患者被纳入研究,无论是否有剖宫产史、肥胖、无产或存在癌前或恶性病理。分析了人口统计资料、手术结果和并发症细节。并发症分为严重和轻微。结果:该队列包括46名女性,中位年龄为54(40-74)岁,中位体重指数为31 (21-51)kg/m²。有腹部手术史的占58.7%,有剖宫产史的占21.7%(10/46)。中位手术时间56 (35 ~ 95)min,子宫中位重量410 (280 ~ 1036)g。总转换率和并发症发生率均为4.3% (n=2)。无重大并发症。次要并发症包括术中出血不输血控制和术后阴道出血保守处理。住院时间中位数为30(16-72)小时。所有患者均出院,术后无需再手术。结论:vNOTES子宫切除术是一种可行、安全、微创的方法,适用于子宫肿大患者,包括肥胖、既往腹部手术、癌前或恶性指征的患者。它提供了良好的手术效果,低并发症和转换率。本研究支持vNOTES技术在大子宫患者中的广泛应用。
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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来源期刊
CiteScore
2.40
自引率
7.10%
发文量
56
期刊介绍: Journal of the Turkish-German Gynecological Association is the official, open access publication of the Turkish-German Gynecological Education and Research Foundation and Turkish-German Gynecological Association and is published quarterly on March, June, September and December. It is an independent peer-reviewed international journal printed in English language. Manuscripts are reviewed in accordance with “double-blind peer review” process for both reviewers and authors. The target audience of Journal of the Turkish-German Gynecological Association includes gynecologists and primary care physicians interested in gynecology practice. It publishes original works on all aspects of obstertrics and gynecology. The aim of Journal of the Turkish-German Gynecological Association is to publish high quality original research articles. In addition to research articles, reviews, editorials, letters to the editor, diagnostic puzzle are also published. Suggestions for new books are also welcomed. Journal of the Turkish-German Gynecological Association does not charge any fee for article submission or processing.
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