首页|Patient and physician perception of natural orifice transluminal endoscopic appendectomy
Patient and physician perception of natural orifice transluminal endoscopic appendectomy
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NETL
NSTL
万方数据
维普
AIM:To investigate perception of natural orifice transluminal endoscopic surgery (NOTES) as a potential technique for appendectomy.METHODS:One hundred patients undergoing endoscopy and 100 physicians were given a questionnaire describing in detail the techniques of NOTES and laparoscopic appendectomy.They were asked about the reasons for their preference,choice of orifice,and extent of complication risk they were willing to accept.RESULTS:Fifty patients (50%) and only 21 physicians (21%) preferred NOTES (P < 0.001).Patients had previously heard of NOTES less frequently (7% vs 73%,P < 0.001) and had undergone endoscopy more frequently (88% vs 36%,P < 0.001) than physicians.Absence of hernia was the most common reason for NOTES preference in physicians (80% vs 44%,P =0.003),whereas reduced pain was the most common reason in patients (66% vs 52%).Physicians were more likely to refuse NOTES as a novel and unsure technique (P < 0.001) and having an increased risk of infection (P < 0.001).The preferred access site in both groups was colon followed by stomach,with vagina being rarely preferred.In multivariable modeling,those with high-school education [odds ratio (OR):2.68,95%confidence interval (CI):1.23-5.83] and prior colonoscopy (OR:2.10,95% CI:1.05-4.19) were more likely to prefer NOTES over laparoscopic appendectomy.There was a steep decline in NOTES preference with increased rate of procedural complications.Male patients were more likely to consent to their wives vaginal NOTES appendectomy than male physicians (P =0.02).CONCLUSION:The preference of NOTES for appendectomy was greater in patients than physicians and was related to reduced pain and absence of hernia rather than lack of scarring.