Comparison of Surgical Outcomes of Total Laparoscopic Hysterectomy and vNOTES Hysterectomy for Undescended-Enlarged Uteri

• Published in: Journal of investigative surgery Vol. 35; no. 4; pp. 918 - 923
• Main Authors: Kaya, Cihan, Yıldız, Şükrü, Alay, İsmail, Karakaş, Sema, Durmuş, Uğur, Güraslan, Hakan, Ekin, Murat
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 03.04.2022; Taylor & Francis Group
• Subjects: Cross-Sectional Studies; Female; Humans; Hysterectomy; Hysterectomy - adverse effects; Hysterectomy - methods; laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Natural Orifice Endoscopic Surgery - methods; natural orifice surgery; postoperative complications; Pregnancy; Retrospective Studies; Treatment Outcome; Uterus - surgery; laparoscopy; postoperative complications; Hysterectomy; natural orifice surgery
• ISSN: 0894-1939; 1521-0553
• DOI: 10.1080/08941939.2021.1958111

This study aimed to compare the surgical outcomes of laparoscopic hysterectomy (LH) and vaginally assisted natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy procedures in women with undescended-enlarged uteri. This cross-sectional study was conducted with 78 women who underwent LH (48 patients) or vNOTES hysterectomy (30 patients) for benign gynecological pathologies. The dimension of the uterus, operation time, intraoperative blood loss, the presence of peri-, postoperative complications, conversion to laparotomy, pre-, postoperative hemoglobin (Hb), and hematocrit (Hct) levels, postoperative hospital stay, total dose of postoperative analgesics, VAS scores at the postoperative 6 th and 24 th hours, and the final pathology reports were recorded. There was no significant difference between LH and vNOTES hysterectomy groups regarding age (47 vs. 47.5 years, p = 0.92), parity (2 vs. 2, p = 0.74), and BMI (30.8 vs. 28.2 kg/m2, p = 0.31). The patients in the vNOTES hysterectomy group had significantly shorter durations of surgery (45 vs. 160 min) and hospitalization (48 vs. 72 h) than the LH group (p < 0.001, p < 0.001, respectively). The 24 th hour VAS score was lower (VAS score 2 vs. 3, p = 0.003) in favor of the vNOTES hysterectomy group. In matched group analysis, the 24 th hour VAS score (2 vs. 3, p = 0.008), operation time (45 vs. 157, p < 0.001), and hospitalization (48 vs. 72, p < 0.001) were lower in the vNOTES hysterectomy group than the LH group. vNOTES hysterectomy provides favorable outcomes compared to conventional LH considering the shorter operation time, hospitalization, and lower 24 th h VAS score.