经阴道自然孔腔镜内窥镜手术与传统手术在子宫次全脱垂同时行阴道子宫切除术患者子宫骶骨韧带悬吊术中的比较。

IF 0.9 Q4 ORTHOPEDICS Asian Journal of Endoscopic Surgery Pub Date : 2024-06-05 DOI:10.1111/ases.13333
Murat Ekin, Mustafa Cengiz Dura, Sukru Yildiz, Berk Gürsoy, Yagmur Yucebas Yildiz, Keziban Dogan, Cihan Kaya
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引用次数: 0

摘要

简介该研究旨在比较经阴道自然腔道内窥镜手术(vNOTES)与非内窥镜子宫骶骨韧带悬吊术(USLS)对同时行阴道子宫切除术的子宫次全脱垂患者的短期疗效:51名患者接受了vNOTES USLS,而非内窥镜传统USLS组有49名患者。患者的人口统计学信息和围手术期数据(包括手术时间、失血量、术中和术后并发症以及术后住院时间)均来自患者档案。术后随访安排在术后一周和一个月:结果:年龄、体重指数、绝经状态和胎次等人口统计学变量具有可比性,未发现显著差异。vNOTES组和shull组分别有90.2%和69.4%的患者处于绝经期(p = .09)。shull组的手术时间明显更短(p 结论:在子宫次全脱垂患者中,vNOTES USLS与传统USLS相比,具有良好的安全性、更高的附件手术比例以及更好的POP-Q点Ba、Bp、D和TVL改善效果。需要对 vNOTES 与传统 USLS 的短期和长期效果进行评估研究。
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Comparison of transvaginal natural orifice transluminal endoscopic surgery versus conventional surgery for uterosacral ligament suspension in patients who had concomitant vaginal hysterectomy for subtotal uterine prolapse

Introduction

The study aimed to compare the short-term outcomes of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for uterosacral ligament suspension (USLS) versus nonendoscopic USLS in patients with subtotal uterine prolapse who had a concomitant vaginal hysterectomy.

Methods

There were 51 patients who underwent vNOTES USLS, whereas the nonendoscopic conventional USLS group had 49 patients. The information about patient demographics, and perioperative data including the operative duration, blood loss, intraoperative and postoperative complications, and length of postoperative hospital stay were determined from the patients' files. Postoperative follow-up visits were scheduled at the first week and 1 month after surgery.

Results

The demographic variables including age, body mass index, menopausal status, and parity were comparable, and no significant differences were found. A total of 90.2% of the patients in the vNOTES group and 69.4% of the patients in the shull group were at menopause (p = .09). Operation time was significantly shorter in the shull group (p < .001), and the hospitalization period (p = .029) was significantly shorter in the vNOTES group. Ba, Bp, and D points and total vaginal length (TVL) were significantly behind the hymenal ring in patients who had vNOTES USLS procedure (p < .001). None of the patients who had intraoperative significant blood loss required transfusion. One patient in the vNOTES and two patients in the shull group had a postoperative cuff hematoma.

Conclusion

vNOTES USLS has a good safety profile, higher percentage of adnexal surgeries with better improvement on POP-Q points Ba, Bp, D, and TVL compared with classic USLS in patients with subtotal uterine prolapse. Studies evaluating short- and long-term results of vNOTES versus conventional USLS are needed.

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