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经阴道自然腔道内镜手术与传统腹腔镜子宫切除术后盆腔器官脱垂及性功能的比较

Comparison of Pelvic Organ Prolapse and Sexual Function After Vaginal Natural Orifice Transluminal Endoscopic Surgery and Conventional Laparoscopic Hysterectomy.

作者信息

Halisçelik Mesut Ali, Şanlı Cengiz, Bala Mesut, Erdem Selami, Can Behzat, Bağlı İhsan, Obut Mehmet, Akgöl Sedat, Bademkıran Cihan, Arkan Kevser, Erkmen Ali Deniz, Ege Serhat, Oğlak Süleyman Cemil, Kavak Salih Burçin

机构信息

Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Research and Training Hospital, University of Health Sciences, 21070 Diyarbakır, Turkey.

Department of Obstetrics and Gynecology, Fethi Sekin City Hospital, University of Health Sciences, 23119 Elazığ, Turkey.

出版信息

J Clin Med. 2025 Apr 9;14(8):2590. doi: 10.3390/jcm14082590.

Abstract

: In our study, we aimed to comprehensively evaluate the surgical parameters of patients who underwent total laparoscopic hysterectomy (TLH) and vaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy and their effects on the development of pelvic organ prolapse (POP) and sexual function one year later. : This retrospective and comparative study involved a review of medical records for 42 patients who underwent total laparoscopic hysterectomy (TLH) for benign conditions and 42 patients who underwent hysterectomy using vaginal natural orifice transluminal endoscopic surgery (vNOTES) at our clinic between January 2023 and January 2024. Evaluations of preoperative and postoperative pelvic organ prolapse and sexual function were conducted, and the anatomical and functional outcomes of both surgical methods were compared. : In this study, there was no statistically significant difference between the groups in terms of age ( < 0.299), BMI ( < 0.819), parity ( < 0.615), surgical indications and menopausal status ( < 0.535) ( > 0.05). The vNOTES method was found to be significantly shorter than TLH in terms of surgical time (vNOTES: 58 min, TLH: 80 min, < 0.001). However, there was no significant difference between the two methods in terms of preoperative and postoperative hematocrit values, hospital stay and FSFI scores ( > 0.05). Among the POP-Q parameters, a significant difference was observed only in the Aa parameter in favor of the vNOTES method ( < 0.003). : In our study, the vNOTES method provided a shorter surgical time and better anterior vaginal support compared to TLH, but both methods offered similar results in terms of sexual function. More comprehensive studies are needed to clarify the long-term effects.

摘要

在我们的研究中,我们旨在全面评估接受全腹腔镜子宫切除术(TLH)和经阴道自然腔道内镜手术(vNOTES)子宫切除术患者的手术参数,以及它们对一年后盆腔器官脱垂(POP)发展和性功能的影响。

这项回顾性比较研究回顾了2023年1月至2024年1月期间在我们诊所接受良性疾病全腹腔镜子宫切除术(TLH)的42例患者和接受经阴道自然腔道内镜手术(vNOTES)子宫切除术的42例患者的病历。对术前和术后盆腔器官脱垂及性功能进行了评估,并比较了两种手术方法的解剖和功能结果。

在本研究中,两组在年龄(<0.299)、体重指数(<0.819)、产次(<0.615)、手术指征和绝经状态(<0.535)方面无统计学显著差异(>0.05)。发现vNOTES方法在手术时间方面明显短于TLH(vNOTES:58分钟,TLH:80分钟,<0.001)。然而,两种方法在术前和术后血细胞比容值、住院时间和FSFI评分方面无显著差异(>0.05)。在POP-Q参数中,仅在Aa参数上观察到有利于vNOTES方法的显著差异(<0.003)。

在我们的研究中,与TLH相比,vNOTES方法提供了更短的手术时间和更好的阴道前壁支撑,但两种方法在性功能方面提供了相似的结果。需要更全面的研究来阐明长期影响。

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引用本文的文献

本文引用的文献

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Eur J Obstet Gynecol Reprod Biol. 2021 Aug;263:216-222. doi: 10.1016/j.ejogrb.2021.06.019. Epub 2021 Jun 17.
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