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Hysterectomy by Transvaginal Natural Orifice Transluminal Endoscopic Surgery versus Transumbilical Laparoscopic Single-Site Surgery: A Single-Center Experience from East China.
- Source :
-
BioMed Research International . 8/8/2022, p1-7. 7p. - Publication Year :
- 2022
-
Abstract
- Objective. To compare hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (VNOTES) versus transumbilical laparoscopic single-site surgery (LESS) as a minimal invasive technique. Materials and Method. The women undergoing hysterectomy for benign diseases by VNOTES and LESS from January 2020 to June 2021 in a tertiary hospital in Shanghai were retrospectively analyzed. Results. 361 women were included in our study, with 228 in the VNOTES groups, 129 in the LESS groups, and 4 conversions from VNOTES to LESS technique. The length of a VNOTES hysterectomy was shorter than that of LESS (80.76 min versus 112.09 min; MD -31.34 min; 95% CI -40.24 to -22.43 min; P < 0.001). VNOTES hysterectomy has a quicker gas passage by the anus (18.80 versus 36.49 hours, MD -17.68 hours, 95% CI -20.23 to -15.14 hours, P < 0.001) and associated with a shorter length of hospital stay (2.31 versus 3.77 days, MD -1.46 days, 95% CI -1.75 to -1.17 days, P < 0.001), while with no increase in blood loss during the operation (median 50 versus 50 ml, P = 0.25). Besides, the VAS pain score in the 24th hour after the operation was lower (median 0 versus 0.5, P < 0.001) in the VNOTES group. Four unique phases of the learning curve were identified using cumulative analysis: the mean operation time of phase I was 82.81 ± 31.45 min (the initial learning curve of 43 cases), phase II was 72.48 ± 23.66 min (the acquisition of command of 91 cases), phase III was 103.77 ± 45.69 min (the further learning of 26 cases), and phase IV was 73.18 ± 26.89 min (postlearning in 68 cases). Conclusions. VNOTES is noninferior to LESS as a new minimal invasive procedure for hysterectomy, which also allows patients a faster recovery from surgery and to suffer less pain, and its efficiency and feasibility in large uterine need further exploring. [ABSTRACT FROM AUTHOR]
- Subjects :
- *LENGTH of stay in hospitals
*VAGINAL hysterectomy
*HYSTERECTOMY
*CONFIDENCE intervals
*PAIN measurement
*MINIMALLY invasive procedures
*UTERINE diseases
*LAPAROSCOPIC surgery
*SURGERY
*PATIENTS
*RETROSPECTIVE studies
*ACQUISITION of data
*TREATMENT duration
*VISUAL analog scale
*TREATMENT effectiveness
*MEDICAL records
*DESCRIPTIVE statistics
*HYSTEROSCOPY
*EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 23146133
- Database :
- Academic Search Index
- Journal :
- BioMed Research International
- Publication Type :
- Academic Journal
- Accession number :
- 158405602
- Full Text :
- https://doi.org/10.1155/2022/8246761