{"title":"阴道自然孔腔内窥镜手术与腹腔镜单部位手术卵巢囊肿切除术的比较:一项回顾性队列研究。","authors":"Chi-Han Chang, Dah-Ching Ding","doi":"10.1097/JCMA.0000000000000933","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We aimed to compare the outcomes of ovarian cystectomy (OC) performed by vaginal natural orifice transluminal endoscopic surgery (vNOTES) vs transumbilical laparoendoscopic single-site surgery (LESS).</p><p><strong>Methods: </strong>We retrospectively analyzed the data of patients in our hospital who underwent OC either by vNOTES or LESS between January 2015 and September 2021. Demographic data were collected. The primary outcome was the conversion rate. The secondary outcomes were the duration of surgery, length of hospital stay, estimated blood loss, maximum body temperature within 48 hours after operation, and duration of maximum body temperature (hours), among others. Statistical analysis was done using the SPSS software.</p><p><strong>Results: </strong>Exactly 284 patients were screened. The vNOTES and LESS groups consisted of 21 and 47 patients, respectively. There was no significant difference in the conversion rates between the two groups (0 vs 8.5% in vNOTES and LESS, respectively; p = 0.303). Compared with the vNOTES group, the LESS group had a larger cyst diameter (6.00 ± 2.32 vs 4.69 ± 1.29 cm; p = 0.004), more endometriotic cysts (42.6% vs 9.5%; p < 0.001), and more pelvic adhesions requiring adhesiolysis (57.4% vs 19.0%; p = 0.003). At baseline, there were no other differences between the groups. The secondary outcomes included a shorter duration of surgery (70.14 ± 27.30 vs 99.57 ± 36.26 minutes; p = 0.001) and lower estimated blood loss (64.29 ± 39.19 vs 163.43 ± 251.20 mL; p = 0.011) in the vNOTES group. Regression analysis showed the diameter of the ovarian cyst correlated with surgical time. The complication was comparable between the two groups.</p><p><strong>Conclusion: </strong>Above all, the advantages of vNOTES include an absence of visible scars, shorter surgical duration, and less blood loss when compared with LESS. Further large-scale prospective trials should confirm the results of our study.</p>","PeriodicalId":17251,"journal":{"name":"Journal of the Chinese Medical Association","volume":"86 7","pages":"682-687"},"PeriodicalIF":1.9000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparing outcomes of ovarian cystectomy by vaginal natural orifice transluminal endoscopic surgery versus laparoendoscopic single-site surgery: A retrospective cohort study.\",\"authors\":\"Chi-Han Chang, Dah-Ching Ding\",\"doi\":\"10.1097/JCMA.0000000000000933\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>We aimed to compare the outcomes of ovarian cystectomy (OC) performed by vaginal natural orifice transluminal endoscopic surgery (vNOTES) vs transumbilical laparoendoscopic single-site surgery (LESS).</p><p><strong>Methods: </strong>We retrospectively analyzed the data of patients in our hospital who underwent OC either by vNOTES or LESS between January 2015 and September 2021. Demographic data were collected. The primary outcome was the conversion rate. The secondary outcomes were the duration of surgery, length of hospital stay, estimated blood loss, maximum body temperature within 48 hours after operation, and duration of maximum body temperature (hours), among others. Statistical analysis was done using the SPSS software.</p><p><strong>Results: </strong>Exactly 284 patients were screened. The vNOTES and LESS groups consisted of 21 and 47 patients, respectively. There was no significant difference in the conversion rates between the two groups (0 vs 8.5% in vNOTES and LESS, respectively; p = 0.303). Compared with the vNOTES group, the LESS group had a larger cyst diameter (6.00 ± 2.32 vs 4.69 ± 1.29 cm; p = 0.004), more endometriotic cysts (42.6% vs 9.5%; p < 0.001), and more pelvic adhesions requiring adhesiolysis (57.4% vs 19.0%; p = 0.003). At baseline, there were no other differences between the groups. The secondary outcomes included a shorter duration of surgery (70.14 ± 27.30 vs 99.57 ± 36.26 minutes; p = 0.001) and lower estimated blood loss (64.29 ± 39.19 vs 163.43 ± 251.20 mL; p = 0.011) in the vNOTES group. Regression analysis showed the diameter of the ovarian cyst correlated with surgical time. The complication was comparable between the two groups.</p><p><strong>Conclusion: </strong>Above all, the advantages of vNOTES include an absence of visible scars, shorter surgical duration, and less blood loss when compared with LESS. Further large-scale prospective trials should confirm the results of our study.</p>\",\"PeriodicalId\":17251,\"journal\":{\"name\":\"Journal of the Chinese Medical Association\",\"volume\":\"86 7\",\"pages\":\"682-687\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Chinese Medical Association\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/JCMA.0000000000000933\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/4/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Chinese Medical Association","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/JCMA.0000000000000933","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/4/26 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景:我们的目的是比较经阴道自然孔腔内窥镜手术(vNOTES)和经脐腔内窥镜单部位手术(LESS)进行卵巢囊肿切除术(OC)的结果。方法:回顾性分析2015年1月至2021年9月期间在我院接受vNOTES或LESS手术的患者资料。收集了人口统计数据。主要结果是转化率。次要结局包括手术时间、住院时间、估计失血量、术后48小时内最高体温、最高体温持续时间(小时)等。采用SPSS软件进行统计分析。结果:共筛选284例患者。vNOTES组和LESS组分别为21例和47例。两组之间的转化率无显著差异(vNOTES和LESS分别为0和8.5%;P = 0.303)。与vNOTES组相比，LESS组囊肿直径更大(6.00±2.32 vs 4.69±1.29 cm);P = 0.004)，子宫内膜异位囊肿较多(42.6% vs 9.5%;P < 0.001)，更多的盆腔粘连需要粘连松解(57.4% vs 19.0%;P = 0.003)。在基线时，两组之间没有其他差异。次要结果包括手术时间较短(70.14±27.30 vs 99.57±36.26分钟);p = 0.001)和较低的估计失血量(64.29±39.19 vs 163.43±251.20 mL;p = 0.011)。回归分析显示卵巢囊肿直径与手术时间相关。两组之间的并发症具有可比性。结论:最重要的是，与less相比，vNOTES的优点包括无明显疤痕，手术时间短，出血量少。进一步的大规模前瞻性试验将证实我们的研究结果。
Comparing outcomes of ovarian cystectomy by vaginal natural orifice transluminal endoscopic surgery versus laparoendoscopic single-site surgery: A retrospective cohort study.
Background: We aimed to compare the outcomes of ovarian cystectomy (OC) performed by vaginal natural orifice transluminal endoscopic surgery (vNOTES) vs transumbilical laparoendoscopic single-site surgery (LESS).
Methods: We retrospectively analyzed the data of patients in our hospital who underwent OC either by vNOTES or LESS between January 2015 and September 2021. Demographic data were collected. The primary outcome was the conversion rate. The secondary outcomes were the duration of surgery, length of hospital stay, estimated blood loss, maximum body temperature within 48 hours after operation, and duration of maximum body temperature (hours), among others. Statistical analysis was done using the SPSS software.
Results: Exactly 284 patients were screened. The vNOTES and LESS groups consisted of 21 and 47 patients, respectively. There was no significant difference in the conversion rates between the two groups (0 vs 8.5% in vNOTES and LESS, respectively; p = 0.303). Compared with the vNOTES group, the LESS group had a larger cyst diameter (6.00 ± 2.32 vs 4.69 ± 1.29 cm; p = 0.004), more endometriotic cysts (42.6% vs 9.5%; p < 0.001), and more pelvic adhesions requiring adhesiolysis (57.4% vs 19.0%; p = 0.003). At baseline, there were no other differences between the groups. The secondary outcomes included a shorter duration of surgery (70.14 ± 27.30 vs 99.57 ± 36.26 minutes; p = 0.001) and lower estimated blood loss (64.29 ± 39.19 vs 163.43 ± 251.20 mL; p = 0.011) in the vNOTES group. Regression analysis showed the diameter of the ovarian cyst correlated with surgical time. The complication was comparable between the two groups.
Conclusion: Above all, the advantages of vNOTES include an absence of visible scars, shorter surgical duration, and less blood loss when compared with LESS. Further large-scale prospective trials should confirm the results of our study.
期刊介绍：
Journal of the Chinese Medical Association, previously known as the Chinese Medical Journal (Taipei), has a long history of publishing scientific papers and has continuously made substantial contribution in the understanding and progress of a broad range of biomedical sciences. It is published monthly by Wolters Kluwer Health and indexed in Science Citation Index Expanded (SCIE), MEDLINE®, Index Medicus, EMBASE, CAB Abstracts, Sociedad Iberoamericana de Informacion Cientifica (SIIC) Data Bases, ScienceDirect, Scopus and Global Health.
JCMA is the official and open access journal of the Chinese Medical Association, Taipei, Taiwan, Republic of China and is an international forum for scholarly reports in medicine, surgery, dentistry and basic research in biomedical science. As a vehicle of communication and education among physicians and scientists, the journal is open to the use of diverse methodological approaches. Reports of professional practice will need to demonstrate academic robustness and scientific rigor. Outstanding scholars are invited to give their update reviews on the perspectives of the evidence-based science in the related research field. Article types accepted include review articles, original articles, case reports, brief communications and letters to the editor
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