Department of Abdominal, Tumor, Transplant and Vascular Surgery, Cologne-Merheim Medical Center, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
Department for Obstetrics and Gynecology, Holweide Hospital, Neufelder Strasse 32, 51067, Cologne, Germany.
Langenbecks Arch Surg. 2021 Sep;406(6):2045-2052. doi: 10.1007/s00423-021-02105-z. Epub 2021 Mar 31.
We conducted a retrospective observational study in order to identify negative effects of NOTES procedures (Natural Orifice Transluminal Endoscopic Surgery) with transvaginal specimen removal on pregnancy and delivery.
From the total population of 299 patients in our NOTES registry, we tried to contact the 121 patients who were of reproductive age (≤ 45 years) at the time of a transvaginal NOTES procedure. They were interviewed by telephone regarding their desire for children, post NOTES-operation pregnancies, and type of delivery using a structured questionnaire. The collected data was analyzed and compared with current data.
We were able to contact 76 patients (follow-up rate: 62.8%) with a median follow-up of 77 months after surgery (33-129 months). Twenty of 74 participating patients had a desire for children (27.0%). One of them and another's male partner were diagnosed as infertile. Regarding the remaining 18 patients, 14 became pregnant, and three of them became pregnant twice. Considering these 17 pregnancies, there was one miscarriage (5.9%) and one twin birth (5.9%). On average, childbirth occurred 44 months after the NOTES procedure. With regard to the type of delivery, 10 vaginal births (58.8%) and 7 caesarean sections (41.2%) occurred. Thus, the rate of fulfilled desire for children was 77.8%. Compared with the literature, no difference to the normal course could be detected.
There is no sign that the transvaginal approach in Hybrid-NOTES, with removal of the specimen through the vagina, has a negative effect on conception, the course during pregnancy, or the type of delivery.
我们进行了一项回顾性观察研究，旨在确定经阴道标本取出的NOTES 手术（经自然腔道内镜手术）对妊娠和分娩的负面影响。
在我们的NOTES 注册中心的 299 名患者中，我们试图联系 121 名在经阴道NOTES 手术时处于生育年龄（≤45 岁）的患者。我们通过电话使用结构化问卷对他们的生育意愿、NOTES 手术后妊娠和分娩类型进行了采访。收集的数据进行了分析，并与当前数据进行了比较。
我们能够联系到 76 名患者（随访率：62.8%），术后中位随访时间为 77 个月（33-129 个月）。20 名 74 名参与患者中有生育意愿（27.0%）。其中 1 名患者和另 1 名患者的男性伴侣被诊断为不育。对于其余 18 名患者，14 名怀孕，其中 3 名怀孕两次。考虑到这 17 次妊娠，有 1 次流产（5.9%）和 1 次双胞胎（5.9%）。平均而言，分娩发生在 NOTES 手术后 44 个月。就分娩方式而言，10 例阴道分娩（58.8%）和 7 例剖宫产（41.2%）。因此，生育意愿的实现率为 77.8%。与文献相比，未发现与正常过程有差异。
经阴道入路 Hybrid-NOTES 经阴道取出标本不会对受孕、妊娠过程或分娩方式产生负面影响。
