目的:显示机器人辅助阴道NOTES(RvNOTES)治疗IV期子宫内膜异位症的可行性和短期结果在全子宫切除术期间有/无完全盲囊闭塞。
方法:回顾性病例系列。
方法:休斯顿的单一学术三级护理医院,德州,美国。
方法:23例IV期子宫内膜异位症成年女性。
方法:RvNOTES联合全子宫切除术切除重度子宫内膜异位症。
结果:评估患者的各种指标,包括总手术时间,机器人停靠时间,机器人控制台时间,子宫切除时间,估计失血量,使用视觉模拟评分(VAS)的围手术期疼痛,和并发症。平均总手术时间为224.3分钟。该研究还发现,与部分或无闭塞的患者相比,完全闭塞的患者手术时间明显更长,估计失血量更高。术后VAS疼痛评分在六周内显示出显着降低。并发症包括1例输尿管完全横切,盆腔血肿伴感染,阴道脓肿,尿路感染,和肺炎。
结论:我们的研究结果表明,RvNOTES可能是治疗IV期子宫内膜异位症的可行手术方法。即使在死胡同完全消失的情况下。
OBJECTIVE: To show feasibility and short-term outcomes of robot-assisted vaginal NOTES (RvNOTES) for the treatment of stage IV endometriosis during total hysterectomy with/without complete cul-de-sac obliteration.
METHODS: Retrospective
case series.
METHODS: Single academic tertiary care hospital in Houston, Texas, USA.
METHODS: Twenty-three adult women with stage IV endometriosis.
METHODS: RvNOTES with total hysterectomy for excision of severe endometriosis.
RESULTS: Patients were assessed for various metrics including total operative time, robot dock time, robot console time, hysterectomy time, estimated blood loss, perioperative pain using the Visual Analogue Scale (VAS), and complications. The mean total operative time was 224.3 minutes. The study also found that patients with complete cul-de-sac obliteration had significantly longer operative times and higher estimated blood loss compared to those with partial or no obliteration. Postoperative VAS pain scores showed a significant reduction over a 6-week period. Complications included one
case of complete ureteral transection, pelvic hematoma with infection, vaginal abscess, urinary tract infection, and pneumonia.
CONCLUSIONS: Our findings suggest that RvNOTES may be a feasible surgical approach in expert hands for treating stage IV endometriosis, even in cases with complete obliteration of the cul-de-sac.