PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to determine the feasibility of performing omentectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for surgical staging of ovarian and high-risk endometrial malignancies.
UNASSIGNED: This descriptive study was realized in a non-university hospital in Switzerland. Eighteen patients with suspicious adnexal masses or high-risk endometrial cancer underwent surgical staging comprising infracolic omentectomy by vNOTES between May 2020 and April 2023.
UNASSIGNED: Patients underwent oncological surgical staging for suspicious adnexal masses in 14 cases (77.8%) and high-risk endometrial cancer in 4 cases (22.2%). vNOTES omentectomies were performed in all patients without complications. Associated procedures included salpingo-oophorectomy (94.4%), hysterectomy (55.6%), peritoneal biopsies (33.3%), pelvic sentinel lymph node biopsies (22.2%), and appendectomy (5.6%). The median time to perform omentectomies was 9 (4-13) min. All oncological staging were completed by vNOTES. No significant intraoperative complications occurred. We observed 1 case (5.6%) of postoperative fever probably associated with vaginal cuff infection (Clavien-Dindo grade II).
UNASSIGNED: This study demonstrated the feasibility of performing vNOTES oncological staging requiring complex extrapelvic procedures such as infracolic omentectomy, supporting its potential role for managing gynecological malignancies such as ovarian and high-risk endometrial cancers. However, before expanding this approach outside study settings, strong evidence of its feasibility, practical benefits, and long-term oncological outcomes are needed.
UNASSIGNED: This descriptive study was realized in a non-university hospital in Switzerland. Eighteen patients with suspicious adnexal masses or high-risk endometrial cancer underwent surgical staging comprising infracolic omentectomy by vNOTES between May 2020 and April 2023.
UNASSIGNED: Patients underwent oncological surgical staging for suspicious adnexal masses in 14 cases (77.8%) and high-risk endometrial cancer in 4 cases (22.2%). vNOTES omentectomies were performed in all patients without complications. Associated procedures included salpingo-oophorectomy (94.4%), hysterectomy (55.6%), peritoneal biopsies (33.3%), pelvic sentinel lymph node biopsies (22.2%), and appendectomy (5.6%). The median time to perform omentectomies was 9 (4-13) min. All oncological staging were completed by vNOTES. No significant intraoperative complications occurred. We observed 1 case (5.6%) of postoperative fever probably associated with vaginal cuff infection (Clavien-Dindo grade II).
UNASSIGNED: This study demonstrated the feasibility of performing vNOTES oncological staging requiring complex extrapelvic procedures such as infracolic omentectomy, supporting its potential role for managing gynecological malignancies such as ovarian and high-risk endometrial cancers. However, before expanding this approach outside study settings, strong evidence of its feasibility, practical benefits, and long-term oncological outcomes are needed.
摘要：
■本研究旨在确定通过经阴道自然腔道内镜手术（vNOTES）进行网膜切除术以对卵巢和高危子宫内膜恶性肿瘤进行手术分期的可行性。
■这项描述性研究是在瑞士一家非大学医院进行的。在2020年5月至2023年4月期间，通过vNOTES对18例可疑附件肿块或高危子宫内膜癌患者进行了手术分期，包括网膜下切除术。
■患者因可疑附件肿块14例（77.8%）和高危子宫内膜癌4例（22.2%）行肿瘤手术分期。所有患者均进行了vNOTES眼切除术，无并发症。相关手术包括输卵管卵巢切除术（94.4%），子宫切除术（55.6%），腹膜活检（33.3％），盆腔前哨淋巴结活检（22.2%），阑尾切除术（5.6%）。进行眼切除术的中位时间为9（4-13）分钟。所有肿瘤分期均由vNOTES完成。术中无明显并发症发生。我们观察到1例（5.6％）术后发热可能与阴道袖带感染有关（Clavien-DindoII级）。
■这项研究证明了进行vNOTES肿瘤分期的可行性，需要复杂的肾盂外手术，如网膜切除术，支持其在治疗妇科恶性肿瘤如卵巢癌和高危子宫内膜癌方面的潜在作用。然而,在将这种方法扩展到研究设置之外之前，其可行性的有力证据,实际利益,和长期的肿瘤结果是必要的。
■这项描述性研究是在瑞士一家非大学医院进行的。在2020年5月至2023年4月期间，通过vNOTES对18例可疑附件肿块或高危子宫内膜癌患者进行了手术分期，包括网膜下切除术。
■患者因可疑附件肿块14例（77.8%）和高危子宫内膜癌4例（22.2%）行肿瘤手术分期。所有患者均进行了vNOTES眼切除术，无并发症。相关手术包括输卵管卵巢切除术（94.4%），子宫切除术（55.6%），腹膜活检（33.3％），盆腔前哨淋巴结活检（22.2%），阑尾切除术（5.6%）。进行眼切除术的中位时间为9（4-13）分钟。所有肿瘤分期均由vNOTES完成。术中无明显并发症发生。我们观察到1例（5.6％）术后发热可能与阴道袖带感染有关（Clavien-DindoII级）。
■这项研究证明了进行vNOTES肿瘤分期的可行性，需要复杂的肾盂外手术，如网膜切除术，支持其在治疗妇科恶性肿瘤如卵巢癌和高危子宫内膜癌方面的潜在作用。然而,在将这种方法扩展到研究设置之外之前，其可行性的有力证据,实际利益,和长期的肿瘤结果是必要的。
