空军军医大学学报2025，Vol.46Issue(5)：650-654,5.DOI:10.13276/j.issn.2097-1656.2025.05.015
经阴道自然腔道内镜手术在大子宫全子宫切除术中的临床疗效:一项回顾性队列研究
Clinical efficacy of vaginal natural orifice transluminal endoscopic surgery for total hysterectomy in large uteri:a retrospective cohort study
摘要
Abstract
Objective To compare the clinical efficacy of vaginal natural orifice transluminal endoscopic surgery(vNOTES)and traditional laparoscopic surgery(LAP)for total hysterectomy in large uteri,and to explore the clinical application value of vNOTES.Methods A retrospective analysis was conducted on patients who underwent total hysterectomy for benign lesions with a uterine mass ≥ 500 g at the Department of Gynecology,Wenzhou People's Hospital from January 2021 to January 2023.Patients were divided into vNOTES group(n=56)and LAP group(n=58).The general data,operative time,intraoperative blood loss,postoperative pain scores,hospital stay,postoperative complications,and related functional recovery were compared between the two groups.Results No significant differences were observed in baseline characteristics between the two groups.The vNOTES group demonstrated significantly shorter operative time[(157.31±31.73)min vs(178.37±47.68)min,P=0.007],reduced time to first postoperative flatus[(22.15±5.84)h vs(30.00±8.75)h,P=0.001],shorter hospital stay[(3.05±0.49)d vs(4.33±1.27)d,P=0.001],and lower postoperative pain scores[(1.33±1.36) vs(3.96±1.18),P=0.001)compared to the LAP group.No significant differences were found in intraoperative blood loss,postoperative complication rates,and functional recovery between the two groups.Conclusion vNOTES significantly shortens operative time and hospital stay while reducing postoperative pain scores in total hysterectomy for large uteri,aligning with the concept of enhanced recovery after surgery.It is a promising technique worthy of clinical promotion.关键词
腹腔镜手术/经阴道自然腔道内镜手术/快速康复外科/大子宫/治疗效果/术后并发症Key words
laparoscopic surgery/vaginal natural orifice transluminal endoscopic surgery/enhanced recovery after surgery/large uterus/treatment efficacy/postoperative complications分类
医药卫生引用本文复制引用
郭芳,李玮,刘丽,胡雪艳,郑蓓蓓,张玉阳,陈新艳..经阴道自然腔道内镜手术在大子宫全子宫切除术中的临床疗效:一项回顾性队列研究[J].空军军医大学学报,2025,46(5):650-654,5.基金项目
浙江省自然科学基金(LY18C010003) （LY18C010003）
温州市科技局公益性项目(Y2023017) （Y2023017）
