一项前瞻性队列研究:基层医院阴道辅助NOTES子宫切除术与腹腔镜子宫切除术的手术效果比较

IF 2.1 4区 医学 Q2 SURGERY
Journal of Investigative Surgery Pub Date : 2025-12-01 Epub Date: 2025-06-10 DOI:10.1080/08941939.2025.2515054
Shuying Fang, Yuandan Xia, Jianbo Jin, Jiaren Zhang, Lei Lu
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引用次数: 0

摘要

背景:本研究旨在比较经阴道自然开口腔内内镜手术(vNOTES)和腹腔镜全子宫切除术(TLH)的手术效果。我们还旨在确定在基层医院进行vNOTES子宫切除术的可行性。方法:在2020年9月1日至2024年11月30日期间,本前瞻性队列研究纳入54例无脱垂良性子宫疾病相关子宫切除术指征的患者。将患者分为vNOTES子宫切除术和TLH两组(各27例)。评估手术结果,包括手术时间、出血量、恢复参数和并发症。结果:两组患者术前基线特征具有可比性。vNOTES组平均手术时间更长(187.6 vs 154.4 min, p p p p)。结论:vNOTES子宫切除术在基层医院是可行的,手术效果与TLH相当。接受vNOTES的患者恢复更快,这表明它可以作为TLH的潜在微创替代方法。然而,小样本量值得进一步研究以验证这些发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of Surgical Outcomes Between Vaginally Assisted NOTES Hysterectomy and Laparoscopic Hysterectomy in Primary Hospitals: A Prospective Cohort Study.

Background: This study aimed to compare the operative outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH). We also aimed to determine the feasibility of performing vNOTES hysterectomy in primary hospitals.

Methods: This prospective cohort study enrolled 54 patients with indications for hysterectomy related to benign uterine disease without prolapse, between September 1, 2020, and November 30, 2024. The patients were categorized into two groups: vNOTES hysterectomy and TLH (n = 27 each). Surgical outcomes, including operative time, blood loss, recovery parameters, and complications, were assessed.

Results: Preoperative baseline characteristics were comparable between the two groups. The vNOTES group had a longer mean operative time (187.6 vs. 154.4 min, p < 0.05) and greater median blood loss (100 vs. 30 mL, p < 0.05) compared to the TLH group. However, there were no significant differences in conversion rates, uterine weights, complications, 24-h pain scores, hospital stay, costs, or readmission rates. The vNOTES group demonstrated shorter times to postoperative ambulation, earlier return of bowel function (anal exhaust), and reduced urinary catheter insertion duration (p < 0.05).

Conclusion: vNOTES hysterectomy is feasible in primary hospitals, with surgical outcomes comparable to those of TLH. Patients who underwent vNOTES experienced faster recovery, indicating that it serves as a potential minimally invasive alternative to TLH. However, the small sample size warrants further studies to validate these findings.

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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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