Impact of transvaginal natural orifice transluminal endoscopic surgery on hysterectomy practice.
J Gynecol Obstet Hum Reprod
; 51(1): 102241, 2022 Jan.
Article
en En
| MEDLINE
| ID: mdl-34626848
ABSTRACT
STUDY OBJECTIVE:
To evaluate the impacts of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) on the hysterectomy route and concomitant adnexal surgery at the time of vaginal hysterectomy (VH). MATERIAL ANDMETHODS:
This retrospective study analyzed all hysterectomies performed for benign indications between 1 January 2017 and 31 December 2019. The period preceding the first case of VH and vNOTES BSO was considered as Pre-vNOTES. The period starting from the date of the first case was considered as Post-vNOTES. The rates per route of hysterectomy and the rate of concomitant adnexal surgery at the time of VH were compared between the two periods.RESULTS:
In hysterectomies performed by surgeons who implemented vNOTES, the proportion of the vaginal route increased from 40.1% to 94.3% (P-value < 0.001); the abdominal route decreased from 37.4% to 3.2% (P-value < 0.001); and the laparoscopic route decreased from 22.5% to 2.5% (P-value < 0.001). The rates of concomitant adnexal procedures performed at the time of VH also showed significant changes. While 39.7% of patients did not undergo any concomitant adnexal surgery during the Pre-vNOTES period, this rate dropped to 8.1% after the implementation of vNOTES (P-value < 0.001). Similarly, the rate of bilateral salpingectomy dropped from 49.3% to 14.2% (P-value < 0.001), whereas the rate of BSO increased from 6.8% to 75% (P-value < 0.001).CONCLUSION:
Implementation of vNOTES has led to a significant increase in the rate of VH and the rate of concomitant BSO at the time of VH.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Cirugía Endoscópica por Orificios Naturales
/
Histerectomía Vaginal
Tipo de estudio:
Observational_studies
Límite:
Adult
/
Female
/
Humans
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
J Gynecol Obstet Hum Reprod
Año:
2022
Tipo del documento:
Article