在4565例内科和术后并发症vNOTES子宫切除术:国际注册表队列研究
Andrea Stuart1,2, Johanna Wagenius1,2, Levon Badiglian-Filho3
1Inst of Clinical Sciences, Department of Obstetrics and Gynecology, Lund University, Lund, Sweden.
BJOG : an international journal of obstetrics and gynaecology
|November 18, 2024
概括
经阴道自然孔透光内镜手术 (vNOTES) 和子宫切除术显示出可以接受的并发症率,即使是在学习曲线中. 这项大型队列研究表明,vNOTES与其他微创性子宫切除术方法并无劣势.
科学领域:
- 最少侵入性的妇科手术
- 手术技术 手术技术
- 阴道手术 阴道手术
背景情况:
- 经阴道自然孔透光内镜手术 (vNOTES) 是一种新兴的微创手术,用于切除子宫.
- 评估并发症率和学习曲线效应对于广泛采用至关重要.
研究的目的:
- 评估一大群vNOTES子宫切除术中的手术内和手术后并发症率和转换率.
- 分析外科医生经验对并发症率的影响.
主要方法:
- 基于国际注册的队列研究,包括来自201名外科医生的4565次vNOTES子宫切除 (2015-2024年).
- 术内和术后并发症和转换的描述性分析.
- 与外科医生的经验和学习曲线相对应的并发症率的评估.
主要成果:
- 总体而言,手术内和术后并发症的发生率分别为3.2%和2.5%.
- 转换为腹腔切除术发生在1.6%的患者中,在最初的50例每位外科医生的病例中,这一比例为82%.
- 随着外科手术经验的增加,并发症率显著下降.
结论:
- 注:子宫切除术与大型,多样化的外科手术群体中可接受的并发症率有关.
- 这种技术与其他微创方法相比并没有劣势.
- 外科医生的经验是最小化vNOTES学习曲线期间并发症的关键因素.
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