Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
BJU Int. 2013 Jan;111(1):11-6. doi: 10.1111/j.1464-410X.2012.11494.x.
The aim of this study was to analyse natural orifice transluminal endoscopic surgery (NOTES)-related publications over the last 5 years. A systematic literature search was done to retrieve publications related to NOTES from 2006 to 2011. The following variables were recorded: year of publication; article type; study design; setting; Journal Citation Reports® journal category; authors area of surgical speciality; geographic area of origin; surgical procedure; NOTES technique; NOTES access route; number of clinical cases. A time-trend analysis was performed by comparing early (2006-2008) and late (2009-2011) study periods. Overall, 644 publications were included in the analysis and most papers were found in general surgery journals (50.9%). Studies were most frequently clinical series (43.9%) and animal experimental (48%), with the articles focusing primarily on cholecystectomy, access creation and closure, and peritoneoscopy. Pure NOTES techniques were performed in most of the published reports (85%) with the remaining cases being hybrid NOTES (7.4%) and NOTES-assisted procedures (6.1%). The access routes included transgastric (52.5%), transcolonic (12.3%), transvesical (12.5%), transvaginal (10.5%), and combined (12.3%). From the early to the late period, there was a significant increase in the number of randomised controlled trials (5.6% vs 7.2%) or non-randomised but comparative studies (5.6% vs 22.9%) (P < 0.001) and there was also a significant increase in the number of colorectal procedures and nephrectomies (P = 0.002). Pure NOTES remained the most studied approach over the years but with increased investigation in the field of NOTES-assisted techniques (P = 0.001). There was also a significant increase in the adoption of transvesical access (7% vs 15.6%) (P = 0.007). NOTES is in a developmental stage and much work is still needed to refine techniques, verify safety and document efficacy. Since the first description of the concept of NOTES, >2000 clinical cases, irrespective of specialty, have been reported. NOTES remains a field of intense clinical and experimental research in various surgical specialities.
本研究旨在分析过去 5 年中与经自然腔道内镜手术（NOTES）相关的文献。通过系统文献检索，检索了 2006 年至 2011 年与 NOTES 相关的出版物。记录了以下变量：出版年份；文章类型；研究设计；设置；期刊引文报告®期刊类别；作者的外科专业领域；起源的地理区域；手术程序；NOTES 技术；NOTES 进入途径；临床病例数。通过比较早期（2006-2008 年）和晚期（2009-2011 年）研究期，进行了时间趋势分析。总体而言，纳入分析的出版物有 644 篇，其中大多数论文发表在普通外科杂志上（50.9%）。研究多为临床系列（43.9%）和动物实验（48%），主要集中在胆囊切除术、入路的创建和闭合以及腹膜镜检查。在大多数已发表的报告中采用了纯 NOTES 技术（85%），其余病例为混合 NOTES（7.4%）和 NOTES 辅助手术（6.1%）。入路包括经胃（52.5%）、经结肠（12.3%）、经膀胱（12.5%）、经阴道（10.5%）和联合入路（12.3%）。从早期到晚期，随机对照试验的数量（5.6%比 7.2%）或非随机但对照研究的数量（5.6%比 22.9%）显著增加（P<0.001），结直肠手术和肾切除术的数量也显著增加（P=0.002）。多年来，纯 NOTES 仍然是研究最多的方法，但在 NOTES 辅助技术领域的研究有所增加（P=0.001）。经膀胱入路的应用也显著增加（7%比 15.6%）（P=0.007）。NOTES 仍处于发展阶段，需要进一步完善技术、验证安全性并记录疗效。自 NOTES 概念的首次描述以来，已报告了 >2000 例临床病例，涉及多个专业。NOTES 仍然是各个外科专业领域临床和实验研究的热点。
