Noh Joseph J, Kim Myeong-Seon, Kang Jun-Hyeok, Jung Ji-Hee, Chang Chi-Son, Jeon Jungeun, Kim Tae-Joong
Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03083, Korea.
J Pers Med. 2022 May 26;12(6):875. doi: 10.3390/jpm12060875.
Single-port access (SPA) laparoscopic surgery and vaginal natural orifice transluminal endoscopic surgery (vNOTES) have many advantages. The objective of the present study is to compare patient characteristics, operative details, and postoperative outcomes between the two surgical methods. Patients who were planned to undergo vNOTES or SPA laparoscopic surgery between April 2020 and June 2021 were prospectively enrolled. The surgical method was determined by a single surgeon after imaging results evaluation and a physical exam. Those who had favorable pelvic conditions without any evidence of adhesion were scheduled for vNOTES. A total of 33 patients underwent a vNOTES hysterectomy while 40 patients received a SPA laparoscopic hysterectomy. All surgeries were performed by one surgeon. The proportion of the patients who had a history of vaginal delivery was significantly higher in the vNOTES group. The operative time for port installation was significantly longer in the vNOTES group, but the total operative time was shorter compared to the SPA group. The postoperative pain scores 12 h after the operations were also significantly lower in the vNOTES group. Other surgical outcomes were comparable between the two groups. The present study demonstrated that the early operative outcomes of vNOTES hysterectomy were comparable to those of SPA hysterectomy. It also highlights the importance of adequate patient selection when determining surgical methods based on imaging results and physical examinations.
单孔腹腔镜手术（SPA）和经阴道自然腔道内镜手术（vNOTES）有诸多优势。本研究的目的是比较这两种手术方法在患者特征、手术细节及术后结果方面的差异。前瞻性纳入了2020年4月至2021年6月期间计划接受vNOTES或SPA腹腔镜手术的患者。手术方式由一名外科医生在评估影像学结果和体格检查后确定。盆腔条件良好且无粘连迹象的患者安排行vNOTES手术。共有33例患者接受了vNOTES子宫切除术，40例患者接受了SPA腹腔镜子宫切除术。所有手术均由一名外科医生完成。vNOTES组有阴道分娩史的患者比例显著更高。vNOTES组的端口安装手术时间显著更长，但与SPA组相比，总手术时间更短。vNOTES组术后12小时的疼痛评分也显著更低。两组的其他手术结果相当。本研究表明，vNOTES子宫切除术的早期手术结果与SPA子宫切除术相当。它还强调了在根据影像学结果和体格检查确定手术方法时，进行充分患者选择的重要性。
