Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Public Health, China Medical University, Taichung, Taiwan.
Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
Taiwan J Obstet Gynecol. 2020 Jul;59(4):565-569. doi: 10.1016/j.tjog.2020.05.016.
We aimed to compare the surgical outcomes between hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and laparoscopic total hysterectomy (LTH).
This study is a retrospective chart analysis. From January 1, 2015, to December 31, 2017, a total of 183 patients of reproductive age with an indication for hysterectomy due to non-prolapsed and benign uterine diseases were enrolled. After exclusion, 20 patients were included in the vNOTES group, and 66 patients were included in the LTH group. Various post-operative surgical outcomes such as operative time, blood loss, uterus weight, a decrease in hemoglobin level on post-operative day one, post-operative pain scale, complications, length of hospitalization, and re-admission rate were measured.
No difference was observed between both groups regarding operative time, blood loss, uterine weight, a decrease in hemoglobin level on post-operative day one, complications, hospital stay, and re-admission rate. Patients in the vNOTES group had significantly less post-operative pain compared with those in the LTH group (p = 0.03).
The surgical outcomes of hysterectomy by vNOTES could be similar to those of LTH. Patients undergoing hysterectomy by vNOTES may have less post-operative pain compared with those undergoing LTH. However, the sample size was small, and the results need more evidence to confirm these findings.
本研究旨在比较经阴道自然腔道内镜手术(vNOTES)与腹腔镜全子宫切除术(LTH)治疗非脱垂和良性子宫疾病的手术结局。
这是一项回顾性图表分析研究。2015 年 1 月 1 日至 2017 年 12 月 31 日期间,共有 183 例因非脱垂和良性子宫疾病而需要行子宫切除术的育龄期妇女被纳入研究。排除标准为脱垂和恶性疾病,经排除后,20 例患者被纳入 vNOTES 组,66 例患者被纳入 LTH 组。评估了术后手术结局,包括手术时间、出血量、子宫重量、术后第 1 天血红蛋白下降水平、术后疼痛评分、并发症、住院时间、再入院率。
两组患者的手术时间、出血量、子宫重量、术后第 1 天血红蛋白下降水平、并发症、住院时间、再入院率比较,差异无统计学意义。vNOTES 组患者的术后疼痛评分明显低于 LTH 组(p=0.03)。
vNOTES 行子宫切除术的手术结局可能与 LTH 相似。与 LTH 相比,vNOTES 组患者术后疼痛较轻。然而,本研究样本量较小,需要更多证据来证实这些发现。