背景:自然腔道内镜手术(NOTES)是微创手术领域的一项成就。然而,经阴道自然腔道内镜手术(vNOTES)在妇科手术中的优势尚不清楚.这项研究的主要目的是比较vNOTES与腹腔镜单部位手术,并确定哪种手术更适合妇科手术中的门诊手术。
方法:这项回顾性观察研究在妇科进行,成都市妇女儿童中心医院。从2021年2月至2022年3月,207名入选患者在妇科手术中接受了vNOTES和腹腔镜内镜单部位手术。收集了关于接受非卧床手术的患者的手术相关信息,64名女性接受了vNOTES。
结果:分析了207例患者的多个结局。WilcoxonRank-Sum检验显示,vNOTES组和腹腔镜单部位手术组在术后疼痛评分方面存在统计学上的显着差异(0vs.1分,p=0.026),麻醉持续时间(90vs.101分钟,p=0.025),手术时间(65vs.80分钟,p=0.015),估计失血量(20vs.40毫升,p<0.001),和肠道衰竭时间(12.20vs.17.14h,p<0.001)。用vNOTES治疗带来了方便,在手术中节省时间和出血量以及预后质量方面。
结论:这些综合数据揭示了vNOTES提高手术效率的能力。与腹腔镜内镜单部位手术相比,妇科手术中的vNOTES可能证明了足够的可行性,并为妇科手术中的门诊手术提供了新的医疗策略。
BACKGROUND: Natural orifice transluminal endoscopic surgery (NOTES) is an achievement in the field of minimally invasive surgery. However, the vantage point of vaginal natural orifice transluminal endoscopic surgery (vNOTES) in gynecologicalprocedures remains unclear. The main purpose of this study was to compare vNOTES with laparo-endoscopic single-site surgery, and to determine which procedure is more suitable for ambulatory surgery in gynecologic procedures.
METHODS: This retrospective observational study was conducted at the Department of Gynecology, Chengdu Women\'s and Children\'s Central Hospital. The 207 enrolled patients had accepted vNOTES and laparo-endoscopic single-site surgery in gynecology procedures from February 2021 to March 2022. Surgically relevant information regarding patients who underwent ambulatory surgery was collected, and 64 females underwent vNOTES.
RESULTS: Multiple outcomes were analyzed in 207 patients. The Wilcoxon Rank-Sum test showed that there were statistically significant differences between the vNOTES and laparo-endoscopic single-site surgery groups in terms of postoperative pain score (0 vs. 1 scores, p = 0.026), duration of anesthesia (90 vs. 101 min, p = 0.025), surgery time (65 vs. 80 min, p = 0.015), estimated blood loss (20 vs. 40 mL, p < 0.001), and intestinal exhaustion time (12.20 vs. 17.14 h, p < 0.001). Treatment with vNOTES resulted in convenience, both with respect to time savings and hemorrhage volume in surgery and with respect to the quality of the prognosis.
CONCLUSIONS: These comprehensive data reveal the capacity of vNOTES to increase surgical efficiency. vNOTES in gynecological procedures may demonstrate sufficient feasibility and provide a new medical strategy compared with laparo-endoscopic single-site surgery for ambulatory surgery in gynecological procedures.