PDF(Pubmed)
Abstract：
UNASSIGNED: As the second most common surgery performed on women in the United States, hysterectomy techniques are constantly examined for validity and superiority. The vaginal natural orifice transluminal endoscopic surgery (vNOTES) has increased in popularity since the first vNOTES hysterectomy was performed in 2012. We sought out to evaluate the safety and effectiveness of hysterectomy by vNOTES compared to conventional vaginal hysterectomy for various benign indications.
UNASSIGNED: We searched Scopus, Medline, PubMed, ClinicalTrials.Gov, and the Cochrane Library. Our search included all studies from each respective database\'s inception until September 1, 2023.
UNASSIGNED: We included eligible studies that compare vNOTES hysterectomy versus conventional vaginal hysterectomy for various benign indications, and included at least one of our preselected outcomes. The main outcomes were estimated blood loss (mL), operation time (min), length of hospital stay (d), Visual Analogue Scale pain score at Day 1, intraoperative complications, and postoperative complications.
UNASSIGNED: We analyzed data of our continuous outcomes using RevMan 5.4.1. Continuous outcomes were analyzed using mean difference (MD) and 95% confidence intervals (CIs) under the inverse variance analysis method. We assessed the quality of the studies using the ROBINS-I assessment tool.
UNASSIGNED: We found 4 eligible studies to include in our analysis. Surgeon declared estimated blood loss was found to be similar in both groups (MD=-44.70 [-99.97, 10.57]; P=.11). Also, the total length of hospital stay (in days) was found to be comparable in both groups (MD=-0.16 [-1.62, 1.30]; P=.83). We also found no other statistically significant difference between hysterectomy by vNOTES and vaginal hysterectomy in other studied outcomes, including the duration of the operation, the Visual Analogue Scale Pain score after 1 day, intraoperative complications, and postoperative complications.
UNASSIGNED: vNOTES seems to be associated with a nonsignificant lower surgeon declared estimated blood loss. We found no other significant differences in hospital stay, intraoperative, or postoperative outcomes. Further studies may clarify if other differences in safety or efficacy exist.
UNASSIGNED: We searched Scopus, Medline, PubMed, ClinicalTrials.Gov, and the Cochrane Library. Our search included all studies from each respective database\'s inception until September 1, 2023.
UNASSIGNED: We included eligible studies that compare vNOTES hysterectomy versus conventional vaginal hysterectomy for various benign indications, and included at least one of our preselected outcomes. The main outcomes were estimated blood loss (mL), operation time (min), length of hospital stay (d), Visual Analogue Scale pain score at Day 1, intraoperative complications, and postoperative complications.
UNASSIGNED: We analyzed data of our continuous outcomes using RevMan 5.4.1. Continuous outcomes were analyzed using mean difference (MD) and 95% confidence intervals (CIs) under the inverse variance analysis method. We assessed the quality of the studies using the ROBINS-I assessment tool.
UNASSIGNED: We found 4 eligible studies to include in our analysis. Surgeon declared estimated blood loss was found to be similar in both groups (MD=-44.70 [-99.97, 10.57]; P=.11). Also, the total length of hospital stay (in days) was found to be comparable in both groups (MD=-0.16 [-1.62, 1.30]; P=.83). We also found no other statistically significant difference between hysterectomy by vNOTES and vaginal hysterectomy in other studied outcomes, including the duration of the operation, the Visual Analogue Scale Pain score after 1 day, intraoperative complications, and postoperative complications.
UNASSIGNED: vNOTES seems to be associated with a nonsignificant lower surgeon declared estimated blood loss. We found no other significant differences in hospital stay, intraoperative, or postoperative outcomes. Further studies may clarify if other differences in safety or efficacy exist.
摘要：
■作为美国女性第二常见的手术，子宫切除术技术的有效性和优越性不断检查。自2012年进行首次vNOTES子宫切除术以来，阴道自然腔道内镜手术（vNOTES）越来越受欢迎。我们试图评估vNOTES子宫切除术与传统阴式子宫切除术对各种良性适应症的安全性和有效性。
■我们搜索了Scopus,Medline,PubMed,临床试验。政府，还有Cochrane图书馆.我们的搜索包括所有研究从每个各自的数据库开始，直到2023年9月1日。
我们纳入了符合条件的研究，这些研究比较了vNOTES子宫切除术与常规阴式子宫切除术对各种良性适应症的影响，并包括至少一个我们的预选结果。主要结果是估计失血量（mL），操作时间（分钟），住院时间（d），第1天的视觉模拟疼痛评分，术中并发症，术后并发症。
■我们使用RevMan5.4.1分析了我们连续结果的数据。在逆方差分析方法下，使用均差（MD）和95％置信区间（CI）分析连续结果。我们使用ROBINS-I评估工具评估了研究的质量。
■我们发现4项符合条件的研究包括在我们的分析中。两组中外科医生宣布的估计失血量相似（MD=-44.70[-99.97,10.57]；P=.11）。此外，两组的总住院天数(天)具有可比性(MD=-0.16[-1.62,1.30];P=.83).我们还发现，在其他研究结果中，vNOTES子宫切除术和阴式子宫切除术之间没有其他统计学上的显著差异。包括手术的持续时间，1天后视觉模拟评分疼痛评分，术中并发症,术后并发症。
■vNOTES似乎与外科医生宣布的估计失血量的降低无关。我们在住院期间没有发现其他显著差异，术中,或术后结果。进一步的研究可能会澄清是否存在其他安全性或有效性差异。
■我们搜索了Scopus,Medline,PubMed,临床试验。政府，还有Cochrane图书馆.我们的搜索包括所有研究从每个各自的数据库开始，直到2023年9月1日。
我们纳入了符合条件的研究，这些研究比较了vNOTES子宫切除术与常规阴式子宫切除术对各种良性适应症的影响，并包括至少一个我们的预选结果。主要结果是估计失血量（mL），操作时间（分钟），住院时间（d），第1天的视觉模拟疼痛评分，术中并发症，术后并发症。
■我们使用RevMan5.4.1分析了我们连续结果的数据。在逆方差分析方法下，使用均差（MD）和95％置信区间（CI）分析连续结果。我们使用ROBINS-I评估工具评估了研究的质量。
■我们发现4项符合条件的研究包括在我们的分析中。两组中外科医生宣布的估计失血量相似（MD=-44.70[-99.97,10.57]；P=.11）。此外，两组的总住院天数(天)具有可比性(MD=-0.16[-1.62,1.30];P=.83).我们还发现，在其他研究结果中，vNOTES子宫切除术和阴式子宫切除术之间没有其他统计学上的显著差异。包括手术的持续时间，1天后视觉模拟评分疼痛评分，术中并发症,术后并发症。
■vNOTES似乎与外科医生宣布的估计失血量的降低无关。我们在住院期间没有发现其他显著差异，术中,或术后结果。进一步的研究可能会澄清是否存在其他安全性或有效性差异。
