在进行vNOTES切除术时,我们是否会损害卵巢储备? 来自随机对照试验的结果
Elif Yildiz1, Enes Serhat Coşkun1, Gözde Yildirim Timur1
1Institution: Department of Obstetrics and Gynecology, Gaziosmanpaşa Training and Research Hospital, University of Health Sciences, Mevlana neighborhood, 885th Street, Department of Obstetrics and Gynecology, Gaziosmanpasa, Istanbul, Turkiye.
Journal of minimally invasive gynecology
|February 9, 2026
概括
经阴道自然孔透光内镜手术 (vNOTES) 切除术与传统腹腔镜相比,不会对卵巢储备产生负面影响. 这种最少的侵入性方法也导致了较低的早期术后疼痛.
科学领域:
- 最少侵入性的妇科手术.
- 生殖内分泌学和不孕不育问题
背景情况:
- 双边切除术 (BS) 越来越多地用于永久绝育.
- 传统腹腔镜 (CL) 是标准的手术方法.
- 经阴道自然孔透光内镜手术 (vNOTES) 提供了一个不那么侵入性的替代方案.
研究的目的:
- 为了比较vNOTES与CL对卵巢储备的影响.
- 为了评估血清抗米勒尔激素 (AMH) 和腹膜毛囊数 (AFC) 作为卵巢储备的标志物.
- 评估术后疼痛作为次要结果.
主要方法:
- 预期随机对照试验涉及81名接受机会性BS的女性.
- 参与者被随机分配到vNOTES切除术 (n=35) 或CL (n=46).
- 卵巢储备标记 (AMH,AFC) 和疼痛评分在手术前和手术后3个月被评估.
主要成果:
- 在手术前或手术后3个月的AMH水平或vNOTES和CL组之间的AFC之间没有显著差异.
- 重复测量ANOVA显示AMH没有显著的时间 × 组相互作用.
- 与CL相比,vNOTES组的术后疼痛得分在6小时内显著降低 (p < 0.001).
结论:
- vNOTES切除术是BS的CL的安全替代方案,在3个月后对卵巢储备没有不良影响.
- vNOTES方法与早期术后疼痛的减少有关.
- 建议进行更长的随访时间的大型研究,以进一步评估长期结果.
相关概念视频
Hormonal Control of the Ovarian Cycle
7.0K
The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
7.0K
Trial and Error and Algorithm
429
A problem-solving strategy is a plan of action used to find a solution. Different strategies have distinct action plans. Trial and error involves trying different solutions until one works. For instance, to fix a broken printer, you might check ink levels, ensure the paper tray isn't jammed, and verify the printer's connection to your laptop. This method can be time-consuming but is commonly used. Thomas Edison, for example, used trial and error to find a suitable filament for the light...
429
Clinical Trials: Overview
5.0K
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
5.0K
Clinical Trials
10.9K
Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...
There are four phases in a clinical trial. A phase one...
10.9K
Random Error
9.8K
Random or indeterminate errors originate from various uncontrollable variables, such as variations in environmental conditions, instrument imperfections, or the inherent variability of the phenomena being measured. Usually, these errors cannot be predicted, estimated, or characterized because their direction and magnitude often vary in magnitude and direction even during consecutive measurements. As a result, they are difficult to eliminate. However, the aggregate effect of these errors can be...
9.8K
Random Variables
17.9K
A random variable is a single numerical value that indicates the outcome of a procedure. The concept of random variables is fundamental to the probability theory and was introduced by a Russian mathematician, Pafnuty Chebyshev, in the mid-nineteenth century.
Uppercase letters such as X or Y denote a random variable. Lowercase letters like x or y denote the value of a random variable. If X is a random variable, then X is written in words, and x is given as a number.
For example, let X = the...
Uppercase letters such as X or Y denote a random variable. Lowercase letters like x or y denote the value of a random variable. If X is a random variable, then X is written in words, and x is given as a number.
For example, let X = the...
17.9K


