Objective:To investigate the safety and feasibility of transvaginal natural orifice transluminal endoscopic surgery(vNOTES)of by hysterectomy.Methods:A retrospective cohort study was conducted on clinical datas from patients who underwent total hysterectomy for benign uterine diseases at Meizhou People's Hospital from June 2018 to December 2022.Patients with a uterine volume ≥300 cm3 and without uterine prolapse were divided into vNOTES group and traditional laparoscopic hysterectomy(TLH)group based on the surgical approach.Comparative analysis was performed on the general index,perioperative index,and postoperative recovery index of the two groups.Results:The study included 47 cases in the vNOTES group and 215 cases in the TLH group.The uterine volume in the two groups were 426.03(358.01,531.43)cm3 and 436.14(358.75,579.05)cm3,and there was no statistically significant difference(P＞0.05).There were no significant differences in surgical success rate,intraoperative blood loss,proportion of appendix resection surgeries,intraoperative and postoperative surgical complications,unplanned readmission within 30 days after surgery and postoperative anal exhaust time between the two groups(all P＞0.05).The operation time,duration of catheter indwelling and postoperative hospital stay duration were shorter in the vNOTES group and there was a lower visual analogue scale pain score at 24 hours after surgery,these differences was statistically significant(all P＜0.05).Conclusions:Hysterectomy by vNOTES is safe and feasible for benign diseases with non-prolapsed large uteri in terms of potential benefits such as reduced postoperative pain and enhanced recovery.
万方数据