Bulutlar Eralp, Uluutku Bulutlar Gizem Berfin, Cilli Latife Aslı, Kılıççı Çetin, Şahin Sadık
Zeynep Kamil Women and Child Research and Training Hospital, İstanbul, Turkey.
Haydarpaşa Numune Research and Training Hospital, İstanbul, Turkey.
Minim Invasive Ther Allied Technol. 2025 Aug;34(4):297-302. doi: 10.1080/13645706.2025.2500097. Epub 2025 May 4.
This study compares vaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH) in terms of clinical outcomes, complications, and recovery.
A retrospective study was conducted on 143 patients who underwent hysterectomy for benign gynecologic conditions (vNOTES: 63; TLH: 80). Demographic, intraoperative, and postoperative outcomes were analyzed.
vNOTES had a significantly shorter operative time (87 ± 22 vs. 103 ± 22 min, < .001) and lower blood loss (138 ± 99 vs. 302 ± 132 cm, < .001). Postoperative pain scores were lower on days 1, 3, and 7 ( < .001). Patients ambulated earlier (5.87 ± 1.11 vs. 6.59 ± 1.28 h, < .001) and resumed daily activities faster (6.83 ± 1.1 vs. 7.89 ± 1.17 days, < .001). No significant differences were found in hospital stay ( = .10), intraoperative complications ( = 1.000), or re-intervention/readmission rates ( = 1.000).
vNOTES is a safe, effective alternative to TLH with advantages in efficiency, pain management, and recovery. However, its learning curve may limit widespread use. Further studies are needed to confirm long-term benefits.
本研究比较了经阴道自然腔道内镜手术（vNOTES）和全腹腔镜子宫切除术（TLH）在临床结局、并发症及恢复情况方面的差异。
对143例因良性妇科疾病接受子宫切除术的患者进行回顾性研究（vNOTES组：63例；TLH组：80例）。分析了患者的人口统计学资料、术中及术后结局。
vNOTES组手术时间显著缩短（87±22分钟 vs. 103±22分钟，P<0.001），失血量更低（138±99毫升 vs. 302±132毫升，P<0.001）。术后第1天、第3天和第7天的疼痛评分更低（P<0.001）。患者更早开始活动（5.87±1.11小时 vs. 6.59±1.28小时，P<0.001），更快恢复日常活动（6.83±1.1天 vs. 7.89±1.17天，P<0.001）。住院时间（P = 0.10）、术中并发症（P = 1.000）或再次干预/再入院率（P = 1.000）方面未发现显著差异。
vNOTES是TLH的一种安全、有效的替代方法，在效率、疼痛管理和恢复方面具有优势。然而，其学习曲线可能会限制其广泛应用。需要进一步研究以证实其长期益处。
