Learning Curve Analysis of Transvaginal Natural Orifice Adnexal Surgery.
J Minim Invasive Gynecol
; 27(2): 489-497, 2020 02.
Article
em En
| MEDLINE
| ID: mdl-30980993
ABSTRACT
STUDY OBJECTIVE:
This study was designed to evaluate the learning curve of transvaginal natural orifice surgery (NOS) for adnexal tumors based on the type of procedure (adnexectomy or cystectomy).DESIGN:
Retrospective cohort study.SETTING:
Tertiary-care university hospital. PATIENTS One hundred thirty-six women with adnexal tumors.INTERVENTIONS:
A series of 136 consecutive transvaginal NOS for adnexal tumor were performed between April 2011 and June 2016. Eighty-five patients (62.5%) had undergone cystectomy, and 51 patients (37.5%) had undergone adnexectomy. MEASUREMENTS AND MAINRESULTS:
The transvaginal NOS procedures included vaginal, endoscopic, single-port access techniques and were divided into 2 categories adnexectomy and cystectomy. Operating time was electronically recorded and was defined as the time from the creation of a posterior colpotomy incision until the complete closure of the posterior colpotomy opening. The average operating time for the cystectomy and adnexectomy groups was 42.7 and 37.7 minutes, respectively (pâ¯=â¯.015). The learning curve was analyzed using the cumulative summation method and showed that 36 cases were needed to achieve proficiency in transvaginal NOS for ovarian cystectomy. However, there was no significant cut-off point to determine the number of patients who had undergone adnexectomy.CONCLUSION:
A well-trained gynecologic endoscopist can achieve surgical proficiency in transvaginal NOS cystectomy after 36 cases. It is suggested that the surgical transvaginal NOS procedure should begin with adnexectomy rather than with cystectomy to avoid initial technical challenges.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos em Ginecologia
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Doenças dos Anexos
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Cirurgia Endoscópica por Orifício Natural
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Curva de Aprendizado
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Neoplasias dos Genitais Femininos
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Middle aged
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Pregnancy
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article