腹腔镜辅助经阴道胆囊切除术：单中心初步经验。
Laparoscopic assisted transvaginal cholecystectomy: single centre preliminary experience.
机构信息
Department of Medical and Surgical Sciences and Translational Medicine, St. Andrea Hospital, School of Medicine and Psychology, University Sapienza of Rome, Rome, Italy.
出版信息
Surgeon. 2013;11 Suppl 1:S1-5. doi: 10.1016/j.surge.2012.09.003. Epub 2012 Nov 24.
BACKGROUND
Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a new approach that allows abdominal surgery to be performed through a natural orifice such as the oral cavity, vagina or rectum. We present our preliminary experience of laparoscopic assisted transvaginal cholecystectomy (LATC).
METHODS
Women affected by cholelithiasis, age below 65 years, BMI under 30, ASA I or II, previous full-term pregnancies, and without previous abdominal surgery underwent LATC. Patients' biographic data, operative time, intraoperative and postoperative complications were collected.
RESULTS
We performed 21 LATCs. Median operative time was 58 min. There were no intraoperative complications. The postoperative course was uneventful in all patients. At 1 year there were no complications and no impaired sexual activity.
CONCLUSIONS
The results of NOTES are promising, but currently only hybrid NOTES can be safely performed. LATC seems to guarantee better cosmetic results, less postoperative pain, faster mobilization and shorter hospitalization than laparoscopic cholecystectomy.
背景
经自然腔道内镜外科（NOTES）是一种新的方法，它允许通过口腔、阴道或直肠等自然腔道进行腹部手术。我们报告了腹腔镜辅助经阴道胆囊切除术（LATC）的初步经验。
方法
患有胆石症的女性，年龄<65 岁，BMI<30，ASA I 或 II 级，有过足月妊娠，无既往腹部手术史，接受 LATC。收集患者的人口统计学数据、手术时间、术中及术后并发症。
结果
我们进行了 21 例 LATC。中位手术时间为 58 分钟。无术中并发症。所有患者的术后过程均无异常。1 年后无并发症，且无性功能受损。
结论
NOTES 的结果很有前途，但目前只能安全地进行杂交 NOTES。与腹腔镜胆囊切除术相比，LATC 似乎能保证更好的美容效果、更少的术后疼痛、更快的活动和更短的住院时间。
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