Xian Wu, Xin Li, Aijie Xie, Jia Liu, Tianjiao Liu, Yunyi Su, Ying Liu, Wei Cheng, Ying Jin, Lulu Wang, Yujian Jia, Jianmei Liao, Hui Wang, Xia Yu, Ling Zhang, Yalan Li, Li He, Yonghong Lin, Xiaoqin Gan
{"title":"经阴道自然孔内窥镜手术子宫切除术：一项前瞻性队列研究。","authors":"Xian Wu, Xin Li, Aijie Xie, Jia Liu, Tianjiao Liu, Yunyi Su, Ying Liu, Wei Cheng, Ying Jin, Lulu Wang, Yujian Jia, Jianmei Liao, Hui Wang, Xia Yu, Ling Zhang, Yalan Li, Li He, Yonghong Lin, Xiaoqin Gan","doi":"10.1186/s12905-024-03461-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is widely recognized for its advantages, including reduced postoperative pain and the absence of visible scarring. However, the anatomical specificity required for vNOTES may increase the risk of injury to nearby organs, such as the rectum and bladder. This study aims to evaluate the safety and potential benefits of vNOTES compared to transumbilical laparoendoscopic single-site surgery (LESS) for Hysterectomy.</p><p><strong>Methods: </strong>The Longitudinal Vaginal Natural Orifice Transluminal Endoscopic Surgery Study (LovNOTESS), conducted in Chengdu, China, included 192 patients who underwent hysterectomy between May and October 2023. This study prospectively collected and compared perioperative and follow-up data between the two groups.</p><p><strong>Results: </strong>The vNOTES group demonstrated shorter surgery times, postoperative flatus time, and hospital stays, but it also had a higher conversion rate. Specifically, the vNOTES approach reduced surgery duration by approximately 29.8 min (95% CI: -41.31, -18.34, P < 0.001) but increased intraoperative blood loss by about 41.82 mL (95% CI: 25.81, 57.82, P < 0.001).</p><p><strong>Conclusion: </strong>By combining laparoscopy with traditional vaginal surgery, vNOTES offers advantages such as shorter surgery times, faster postoperative recovery, reduced hospital stays, greater minimal invasiveness, and improved cosmetic outcomes. However, it is essential for surgeons to continually enhance and standardize preoperative assessments and surgical techniques to minimize conversion rates and reduce intraoperative blood loss.</p><p><strong>Trial registry number: </strong>ChiCTR2200059282, China Clinical Trials Registry, April 28, 2022.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"24 1","pages":"631"},"PeriodicalIF":2.4000,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606056/pdf/","citationCount":"0","resultStr":"{\"title\":\"Transvaginal natural orifice endoscopic surgery for hysterectomy: a prospective cohort study.\",\"authors\":\"Xian Wu, Xin Li, Aijie Xie, Jia Liu, Tianjiao Liu, Yunyi Su, Ying Liu, Wei Cheng, Ying Jin, Lulu Wang, Yujian Jia, Jianmei Liao, Hui Wang, Xia Yu, Ling Zhang, Yalan Li, Li He, Yonghong Lin, Xiaoqin Gan\",\"doi\":\"10.1186/s12905-024-03461-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is widely recognized for its advantages, including reduced postoperative pain and the absence of visible scarring. However, the anatomical specificity required for vNOTES may increase the risk of injury to nearby organs, such as the rectum and bladder. This study aims to evaluate the safety and potential benefits of vNOTES compared to transumbilical laparoendoscopic single-site surgery (LESS) for Hysterectomy.</p><p><strong>Methods: </strong>The Longitudinal Vaginal Natural Orifice Transluminal Endoscopic Surgery Study (LovNOTESS), conducted in Chengdu, China, included 192 patients who underwent hysterectomy between May and October 2023. This study prospectively collected and compared perioperative and follow-up data between the two groups.</p><p><strong>Results: </strong>The vNOTES group demonstrated shorter surgery times, postoperative flatus time, and hospital stays, but it also had a higher conversion rate. Specifically, the vNOTES approach reduced surgery duration by approximately 29.8 min (95% CI: -41.31, -18.34, P < 0.001) but increased intraoperative blood loss by about 41.82 mL (95% CI: 25.81, 57.82, P < 0.001).</p><p><strong>Conclusion: </strong>By combining laparoscopy with traditional vaginal surgery, vNOTES offers advantages such as shorter surgery times, faster postoperative recovery, reduced hospital stays, greater minimal invasiveness, and improved cosmetic outcomes. However, it is essential for surgeons to continually enhance and standardize preoperative assessments and surgical techniques to minimize conversion rates and reduce intraoperative blood loss.</p><p><strong>Trial registry number: </strong>ChiCTR2200059282, China Clinical Trials Registry, April 28, 2022.</p>\",\"PeriodicalId\":9204,\"journal\":{\"name\":\"BMC Women's Health\",\"volume\":\"24 1\",\"pages\":\"631\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-11-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606056/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Women's Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12905-024-03461-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Women's Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12905-024-03461-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Transvaginal natural orifice endoscopic surgery for hysterectomy: a prospective cohort study.
Objective: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is widely recognized for its advantages, including reduced postoperative pain and the absence of visible scarring. However, the anatomical specificity required for vNOTES may increase the risk of injury to nearby organs, such as the rectum and bladder. This study aims to evaluate the safety and potential benefits of vNOTES compared to transumbilical laparoendoscopic single-site surgery (LESS) for Hysterectomy.
Methods: The Longitudinal Vaginal Natural Orifice Transluminal Endoscopic Surgery Study (LovNOTESS), conducted in Chengdu, China, included 192 patients who underwent hysterectomy between May and October 2023. This study prospectively collected and compared perioperative and follow-up data between the two groups.
Results: The vNOTES group demonstrated shorter surgery times, postoperative flatus time, and hospital stays, but it also had a higher conversion rate. Specifically, the vNOTES approach reduced surgery duration by approximately 29.8 min (95% CI: -41.31, -18.34, P < 0.001) but increased intraoperative blood loss by about 41.82 mL (95% CI: 25.81, 57.82, P < 0.001).
Conclusion: By combining laparoscopy with traditional vaginal surgery, vNOTES offers advantages such as shorter surgery times, faster postoperative recovery, reduced hospital stays, greater minimal invasiveness, and improved cosmetic outcomes. However, it is essential for surgeons to continually enhance and standardize preoperative assessments and surgical techniques to minimize conversion rates and reduce intraoperative blood loss.
Trial registry number: ChiCTR2200059282, China Clinical Trials Registry, April 28, 2022.
期刊介绍：
BMC Women''s Health is an open access, peer-reviewed journal that considers articles on all aspects of the health and wellbeing of adolescent girls and women, with a particular focus on the physical, mental, and emotional health of women in developed and developing nations. The journal welcomes submissions on women''s public health issues, health behaviours, breast cancer, gynecological diseases, mental health and health promotion.
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