Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery for nonprolapsed uteri

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• 作者：Chin-Jung Wang ; Hui-Yu Huang ; Chen-Ying Huang ; Hsuan Su
• 关键词：Hysterectomy ; Natural orifice transluminal endoscopic surgery ; NOTES ; Uterus
• 刊名：Surgical Endoscopy
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：29
• 期：1
• 页码：100-107
• 全文大小：731 KB
• 参考文献：1. American Congress of Obstetricians and Gynecologists (ACOG) Committee Opinion No. 444 (2009) Choosing the route of hysterectomy for benign disease. Obstet Gynecol 114:1156-158 CrossRef
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  3. Hwang JL, Seow KM, Tsai YL, Huang LW, Hsieh BC, Lee C (2002) Comparative study of vaginal, laparoscopically assisted vaginal and abdominal hysterectomies for uterine myoma larger than 6?cm in diameter or uterus weighing at least 450?g: a prospective randomized study. Acta Obstet Gynecol Scand 81:1132-138 CrossRef
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Gynecology
  Gastroenterology
  Hepatology
  Proctology
  Abdominal Surgery
  
• 出版者：Springer New York
• ISSN：1432-2218

文摘

Background Natural orifice transluminal endoscopic surgery has shown its prospection as a minimally invasive endoscopic surgery. This study aimed to examine the safety and feasibility of transvaginal natural orifice transluminal endoscopic hysterectomy (tVNOTEH) for nonprolapsed uteri in the management of benign gynecological diseases. Methods Records were reviewed for the 147 consecutive tVNOTEH procedures between April 2011 and October 2013. Age, body mass index, number of vaginal delivery, and specimen weight were used to select comparable patient who had undergone laparoscopically assisted vaginal hysterectomy (LAVH). Results A total of 512 patients were recruited in this study (147 tVNOTEHs and 365 LAVHs, respectively). These patients were stratified into six subgroups according to the uterine weight and type of hysterectomy. There was no incidence of switching to abdominal laparatomy. Length of operation, estimated blood loss (EBL), requirement of blood transfusion, and length of postoperative stay were significantly greater in the LAVH group than in the tVNOTEH group but total hospital charges were higher in the tVNOTEH group (p?p? Conclusion tVNOTEH can be safely performed for large and nonprolapsed uterus. Besides, as uterine weight increased, the operative efficiency of tVNOTEH increases compared with LAVH.