{"title":"子宫切除术与腹腔镜子宫切除术：三级中心的经验和结果。","authors":"Eralp Bulutlar, Gizem Berfin Uluutku Bulutlar, Latife Aslı Cilli, Çetin Kılıççı, Sadık Şahin","doi":"10.1080/13645706.2025.2500097","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study compares vaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH) in terms of clinical outcomes, complications, and recovery.</p><p><strong>Methods: </strong>A retrospective study was conducted on 143 patients who underwent hysterectomy for benign gynecologic conditions (vNOTES: 63; TLH: 80). Demographic, intraoperative, and postoperative outcomes were analyzed.</p><p><strong>Results: </strong>vNOTES had a significantly shorter operative time (87 ± 22 vs. 103 ± 22 min, <i>p</i> < .001) and lower blood loss (138 ± 99 vs. 302 ± 132 cm<sup>3</sup>, <i>p</i> < .001). Postoperative pain scores were lower on days 1, 3, and 7 (<i>p</i> < .001). Patients ambulated earlier (5.87 ± 1.11 vs. 6.59 ± 1.28 h, <i>p</i> < .001) and resumed daily activities faster (6.83 ± 1.1 vs. 7.89 ± 1.17 days, <i>p</i> < .001). No significant differences were found in hospital stay (<i>p</i> = .10), intraoperative complications (<i>p</i> = 1.000), or re-intervention/readmission rates (<i>p</i> = 1.000).</p><p><strong>Conclusions: </strong>vNOTES is a safe, effective alternative to TLH with advantages in efficiency, pain management, and recovery. However, its learning curve may limit widespread use. Further studies are needed to confirm long-term benefits.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-6"},"PeriodicalIF":1.7000,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"vNOTES hysterectomy versus laparoscopic hysterectomy: experiences and outcomes in a tertiary center.\",\"authors\":\"Eralp Bulutlar, Gizem Berfin Uluutku Bulutlar, Latife Aslı Cilli, Çetin Kılıççı, Sadık Şahin\",\"doi\":\"10.1080/13645706.2025.2500097\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study compares vaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH) in terms of clinical outcomes, complications, and recovery.</p><p><strong>Methods: </strong>A retrospective study was conducted on 143 patients who underwent hysterectomy for benign gynecologic conditions (vNOTES: 63; TLH: 80). Demographic, intraoperative, and postoperative outcomes were analyzed.</p><p><strong>Results: </strong>vNOTES had a significantly shorter operative time (87 ± 22 vs. 103 ± 22 min, <i>p</i> < .001) and lower blood loss (138 ± 99 vs. 302 ± 132 cm<sup>3</sup>, <i>p</i> < .001). Postoperative pain scores were lower on days 1, 3, and 7 (<i>p</i> < .001). Patients ambulated earlier (5.87 ± 1.11 vs. 6.59 ± 1.28 h, <i>p</i> < .001) and resumed daily activities faster (6.83 ± 1.1 vs. 7.89 ± 1.17 days, <i>p</i> < .001). No significant differences were found in hospital stay (<i>p</i> = .10), intraoperative complications (<i>p</i> = 1.000), or re-intervention/readmission rates (<i>p</i> = 1.000).</p><p><strong>Conclusions: </strong>vNOTES is a safe, effective alternative to TLH with advantages in efficiency, pain management, and recovery. However, its learning curve may limit widespread use. Further studies are needed to confirm long-term benefits.</p>\",\"PeriodicalId\":18537,\"journal\":{\"name\":\"Minimally Invasive Therapy & Allied Technologies\",\"volume\":\" \",\"pages\":\"1-6\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-05-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Minimally Invasive Therapy & Allied Technologies\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/13645706.2025.2500097\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minimally Invasive Therapy & Allied Technologies","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13645706.2025.2500097","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景：本研究比较了阴道自然腔内内镜手术（vNOTES）和腹腔镜全子宫切除术（TLH）的临床结果、并发症和恢复情况。方法：对143例因良性妇科疾病行子宫切除术的患者进行回顾性研究(vNOTES: 63；子宫切除术:80)。对人口统计学、术中及术后结果进行分析。结果：vNOTES手术时间明显缩短（87±22 vs 103±22 min, p3, p3 p p p p = 0.10），术中并发症（p = 1.000），再干预/再入院率（p = 1.000）。结论：vNOTES是TLH的一种安全、有效的替代方法，在效率、疼痛管理和恢复方面具有优势。然而，它的学习曲线可能会限制其广泛使用。需要进一步的研究来证实长期的益处。
vNOTES hysterectomy versus laparoscopic hysterectomy: experiences and outcomes in a tertiary center.
Background: This study compares vaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH) in terms of clinical outcomes, complications, and recovery.
Methods: A retrospective study was conducted on 143 patients who underwent hysterectomy for benign gynecologic conditions (vNOTES: 63; TLH: 80). Demographic, intraoperative, and postoperative outcomes were analyzed.
Results: vNOTES had a significantly shorter operative time (87 ± 22 vs. 103 ± 22 min, p < .001) and lower blood loss (138 ± 99 vs. 302 ± 132 cm3, p < .001). Postoperative pain scores were lower on days 1, 3, and 7 (p < .001). Patients ambulated earlier (5.87 ± 1.11 vs. 6.59 ± 1.28 h, p < .001) and resumed daily activities faster (6.83 ± 1.1 vs. 7.89 ± 1.17 days, p < .001). No significant differences were found in hospital stay (p = .10), intraoperative complications (p = 1.000), or re-intervention/readmission rates (p = 1.000).
Conclusions: vNOTES is a safe, effective alternative to TLH with advantages in efficiency, pain management, and recovery. However, its learning curve may limit widespread use. Further studies are needed to confirm long-term benefits.
期刊介绍：
Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.
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