Kemal Güngördük, Varol Gülseren, Berican Şahin Uyar, Özgün Akbaş, Serkan Üstüntaş, Emre Biton, İsa Aykut Özdemir
{"title":"阴道自然孔腔内窥镜手术子宫切除术是否可以用于子宫肿大的患者？","authors":"Kemal Güngördük, Varol Gülseren, Berican Şahin Uyar, Özgün Akbaş, Serkan Üstüntaş, Emre Biton, İsa Aykut Özdemir","doi":"10.1111/jog.16345","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>In this study, the application of vaginal natural orifice transluminal endoscopic surgery (vNOTES) and conventional laparoscopy (CLS) underwent hysterectomy in patients with enlarged uterus was compared.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This multicenter study enrolled patients with an enlarged uterus (≥300 g) who underwent minimally invasive hysterectomy using either CLS or vNOTES in the Department of Obstetrics and Gynecology between January 2020 and December 2024.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among the enrolled patients with an enlarged uterus, 39 (65.0%) underwent conventional laparoscopy, and 21 (35.0%) underwent vNOTES. The median operative times were 80 (50–140) min in the conventional laparoscopy group and 70 (60–130) min in the vNOTES group (<i>p</i> = 0.008). Median blood loss was significantly lower in the vNOTES group (140 [80–210] vs. 160 [90–370] mL; <i>p</i> = 0.013). The length of hospital stay was comparable between groups. Intraoperative bladder injury occurred in one patient in each group—conventional laparoscopy (2.6%) and vNOTES (4.8%) (<i>p</i> = 0.651). Conversion to laparotomy was required in three patients (7.7%) in the CLS group and one patient (4.8%) in the vNOTES group (<i>p</i> = 0.664). The visual analog scale pain score was significantly lower in the vNOTES group at 6, 12, and 24 h postoperatively.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>vNOTES was confirmed to be a safe, feasible, and effective approach for hysterectomy in patients with an enlarged uterus.</p>\n </section>\n </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 6","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Can vaginal natural orifice transluminal endoscopic surgery hysterectomy be performed in patients with an enlarged uterus?\",\"authors\":\"Kemal Güngördük, Varol Gülseren, Berican Şahin Uyar, Özgün Akbaş, Serkan Üstüntaş, Emre Biton, İsa Aykut Özdemir\",\"doi\":\"10.1111/jog.16345\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>In this study, the application of vaginal natural orifice transluminal endoscopic surgery (vNOTES) and conventional laparoscopy (CLS) underwent hysterectomy in patients with enlarged uterus was compared.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This multicenter study enrolled patients with an enlarged uterus (≥300 g) who underwent minimally invasive hysterectomy using either CLS or vNOTES in the Department of Obstetrics and Gynecology between January 2020 and December 2024.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Among the enrolled patients with an enlarged uterus, 39 (65.0%) underwent conventional laparoscopy, and 21 (35.0%) underwent vNOTES. The median operative times were 80 (50–140) min in the conventional laparoscopy group and 70 (60–130) min in the vNOTES group (<i>p</i> = 0.008). Median blood loss was significantly lower in the vNOTES group (140 [80–210] vs. 160 [90–370] mL; <i>p</i> = 0.013). The length of hospital stay was comparable between groups. Intraoperative bladder injury occurred in one patient in each group—conventional laparoscopy (2.6%) and vNOTES (4.8%) (<i>p</i> = 0.651). Conversion to laparotomy was required in three patients (7.7%) in the CLS group and one patient (4.8%) in the vNOTES group (<i>p</i> = 0.664). 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Can vaginal natural orifice transluminal endoscopic surgery hysterectomy be performed in patients with an enlarged uterus?
Aim
In this study, the application of vaginal natural orifice transluminal endoscopic surgery (vNOTES) and conventional laparoscopy (CLS) underwent hysterectomy in patients with enlarged uterus was compared.
Methods
This multicenter study enrolled patients with an enlarged uterus (≥300 g) who underwent minimally invasive hysterectomy using either CLS or vNOTES in the Department of Obstetrics and Gynecology between January 2020 and December 2024.
Results
Among the enrolled patients with an enlarged uterus, 39 (65.0%) underwent conventional laparoscopy, and 21 (35.0%) underwent vNOTES. The median operative times were 80 (50–140) min in the conventional laparoscopy group and 70 (60–130) min in the vNOTES group (p = 0.008). Median blood loss was significantly lower in the vNOTES group (140 [80–210] vs. 160 [90–370] mL; p = 0.013). The length of hospital stay was comparable between groups. Intraoperative bladder injury occurred in one patient in each group—conventional laparoscopy (2.6%) and vNOTES (4.8%) (p = 0.651). Conversion to laparotomy was required in three patients (7.7%) in the CLS group and one patient (4.8%) in the vNOTES group (p = 0.664). The visual analog scale pain score was significantly lower in the vNOTES group at 6, 12, and 24 h postoperatively.
Conclusion
vNOTES was confirmed to be a safe, feasible, and effective approach for hysterectomy in patients with an enlarged uterus.
期刊介绍：
The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology.
The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.
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