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早期子宫内膜癌腹腔镜手术与经阴道自然腔道内镜手术的比较

Comparison of laparoscopy and vNOTES in early-stage endometrial cancer.

作者信息

Mat Emre, Keles Esra, Dereli Murat Levent, Sucu Serap Topkara, Kartal Özgür, Solmaz Ulaş, Yıldız Pınar, Yıldız Gazi

机构信息

Department of Gynecologic Oncology, University of Health Sciences, Kartal Lütfi Kırdar City Hospital, Istanbul, Turkey.

Division of Perinatology, Department of Obstetrics and Gynecology, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Turkey.

出版信息

J Obstet Gynaecol Res. 2024 Sep;50(9):1649-1654. doi: 10.1111/jog.16054. Epub 2024 Aug 19.

Abstract

AIM

To compare the demographic, clinical, surgical, histopathological, and oncological outcomes of vNOTES and conventional laparoscopy (CL)for early-stage endometrial cancer.

METHODS

A retrospective study was carried out in the Gynecologic Clinic of a tertiary hospital from January 2019 to November 2020. Patient demographic characteristics, surgical outcomes, histopathological characteristics, visual analog scale (VAS) pain scores at postoperative 6th, 12th, and 24th, intra- and postoperative complications, and follow-up results were noted.

RESULTS

A total of 45 patients enrolled, of which 16 underwent CL and 29 were vNOTES. The operative time and decrease in hemoglobin levels were similar for both groups (p = 0.202, p = 0.699). Postoperative hospital stay did not differ between the vNOTES group and the CL group (p = 0.549). VAS pain scores at postoperative 6th, 12th, and 24th h were significantly lower in vNOTES group than in the CL group (p < 0.001). The requirement for additional opioid/narcotic analgesic was lower in the vNOTES group than in the CL group (p = 0.037).

CONCLUSION

vNOTES may be a safe and feasible option in early-stage endometrial cancer, having less postoperative pain and less requirement of opioid/narcotic analgesic compared with laparoscopy.

摘要

目的

比较单孔腹腔镜手术(vNOTES)与传统腹腔镜手术(CL)治疗早期子宫内膜癌的人口统计学、临床、手术、组织病理学及肿瘤学结局。

方法

于2019年1月至2020年11月在一家三级医院的妇科门诊进行一项回顾性研究。记录患者的人口统计学特征、手术结局、组织病理学特征、术后第6、12和24小时的视觉模拟评分(VAS)疼痛评分、术中和术后并发症以及随访结果。

结果

共纳入45例患者,其中16例行CL手术,29例行vNOTES手术。两组的手术时间和血红蛋白水平下降情况相似(p = 0.202,p = 0.699)。vNOTES组和CL组的术后住院时间无差异(p = 0.549)。vNOTES组术后第6、12和24小时的VAS疼痛评分显著低于CL组(p < 0.001)。vNOTES组对额外阿片类/麻醉性镇痛药的需求低于CL组(p = 0.037)。

结论

对于早期子宫内膜癌,vNOTES可能是一种安全可行的选择,与腹腔镜手术相比,术后疼痛较轻,对阿片类/麻醉性镇痛药的需求较少。

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