Qian Panlian, Chen Weimin, Su Bin, Chen Yao, Shan Wulin, Tang Huimin, Wei Weiwei, Wang Huihui, Xia Bairong, Chen Jiming
Department of Obstetrics and Gynecology, Tongxiang Maternal and Child Health Hospital, Jiaxing, 314000, People's Republic of China.
Department of Gynecology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230031, People's Republic of China.
Eur J Med Res. 2024 Dec 19;29(1):605. doi: 10.1186/s40001-024-02202-x.
To investigate the feasibility and safety of Transvaginal Natural Orifice Transluminal Endoscopic Surgery (V-NOTES) panhysterectomy.
A retrospective analysis was conducted on the data of 75 patients who underwent panhysterectomy for hysteromyoma in the Department of Obstetrics and Gynecology of Tongxiang Maternal and Child Health Hospital; Department of Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University and Department of Gynecology, The First Affiliated Hospital of USTC from June 2019 to June 2020. According to the operation mode, the patients were divided into two groups: the traditional multi-port laparoscopic surgery (MPLS) group (n = 45) and the Transvaginal Natural Orifice Transluminal Endoscopic Surgery (V-NOTES) group (n = 30). The operation duration, intraoperative blood loss, postoperative exsufflation time, postoperative activity time, hospital stay, treatment cost, 6 h activities of daily living (ADL) score after the operation, cosmetic score, visual analog score, and complications were observed in the two groups.
Perioperative period related indicators: Compared with the MPLS group, the total treatment cost and cosmetic score of the V-NOTES group were significantly better than those of the MPLS group, but the operation duration was longer, and the HB decreased more significantly (P < 0.05). However, there was no significant difference in intraoperative blood loss, postoperative exsufflation time, postoperative activity time, 6 h ADL score after the operation, and hospital stay between the two groups (P > 0.05). Postoperative pain: The VAS score 1 h, 6 h, 12 h, and 24 h after the operation was lower in the V-NOTES group than in the MPLS group (P < 0.05). Postoperative complications: The complication rate of the V-NOTES group was significantly lower than that of the MPLS group (P < 0.05).
In treating panhysterectomy patients, both V-NOTES and MPLS can achieve satisfactory efficacy and prognosis, and both have advantages and disadvantages. Specifically, the V-NOTES surgery has significant advantages such as a lower treatment cost, lower incidence of postoperative complications, less pain, and more beautiful wounds.
探讨经阴道自然腔道内镜手术（V-NOTES）全子宫切除术的可行性及安全性。
回顾性分析2019年6月至2020年6月在桐乡市妇幼保健院妇产科、南京医科大学附属常州第二人民医院妇科、中国科学技术大学附属第一医院妇科因子宫肌瘤行全子宫切除术的75例患者的资料。根据手术方式将患者分为两组：传统多孔腹腔镜手术（MPLS）组（n = 45）和经阴道自然腔道内镜手术（V-NOTES）组（n = 30）。观察两组患者的手术时间、术中出血量、术后排气时间、术后活动时间、住院时间、治疗费用、术后6小时日常生活活动（ADL）评分、美容评分、视觉模拟评分及并发症情况。
围手术期相关指标：与MPLS组相比，V-NOTES组的总治疗费用和美容评分明显优于MPLS组，但手术时间较长，血红蛋白（HB）下降更明显（P < 0.05）。然而，两组患者的术中出血量、术后排气时间、术后活动时间、术后6小时ADL评分及住院时间比较，差异无统计学意义（P > 0.05）。术后疼痛：V-NOTES组术后1小时、6小时、12小时及24小时的视觉模拟评分（VAS）均低于MPLS组（P < 0.05）。术后并发症：V-NOTES组的并发症发生率明显低于MPLS组（P < 0.05）。
在治疗全子宫切除术患者时，V-NOTES和MPLS均能取得满意的疗效和预后，且各有优缺点。具体而言，V-NOTES手术具有治疗费用低、术后并发症发生率低、疼痛轻、伤口美观等显著优势。
