Transvaginal endoscopic surgery-assisted versus conventional laparoscopic adnexectomy (TVEA vs . CLA): A propensity-matched study and literature review

Abstract Objective Natural orifice transluminal endoscopic surgery (NOTES) may be useful in gynecologic endoscopic surgery. This study evaluated the efficacy, safety, and perioperative outcomes of combined NOTES and vaginal approach, transvaginal endoscopic surgery-assisted adnexectomy (TVEA), for t...

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Published inTaiwanese journal of obstetrics & gynecology Vol. 56; no. 3; pp. 336 - 341
Main Authors Li, Yi-Chieh, Ku, Fei-Chun, Kuo, Hsin-Hong, Tseng, Hsiao-Jung, Wang, Chin-Jung
Format Journal Article
LanguageEnglish
Published China (Republic : 1949- ) Elsevier B.V 01.06.2017
Elsevier
Subjects
Adnexectomy
Aged
Aged, 80 and over
Blood Loss, Surgical
Female
Humans
Internal Medicine
Laparoscopy
Length of Stay
Middle Aged
Natural Orifice Endoscopic Surgery - methods
Natural orifice transluminal endoscopic surgery
Obstetrics and Gynecology
Operative Time
Ovarian Neoplasms - surgery
Ovary
Pregnancy
Propensity Score
Retrospective Studies
Vagina
Vaginal
Ovary
Laparoscopy
Natural orifice transluminal endoscopic surgery
Adnexectomy
Vaginal
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Summary:Abstract Objective Natural orifice transluminal endoscopic surgery (NOTES) may be useful in gynecologic endoscopic surgery. This study evaluated the efficacy, safety, and perioperative outcomes of combined NOTES and vaginal approach, transvaginal endoscopic surgery-assisted adnexectomy (TVEA), for the surgical treatment of presumed benign ovarian tumors. Materials and methods Records were reviewed for 33 consecutive TVEA procedures performed between May 2011 and March 2014. Patient age, body mass index, parity, mass size, and mass bilaterality were used to select comparable patients who had undergone conventional laparoscopic adnexectomy (CLA). Results A total of 236 patients were included in this study (203 CLAs and 33 TVEAs). No cases switched to abdominal laparotomy. Operating time and length of postoperative stay were significantly longer in the CLA group than in the TVEA group, while total hospital charges were higher in the TVEA group ( p  < 0.001). There was no difference in febrile morbidity between the two groups; while the estimated blood loss was higher in the TVEA group, the EBL was <30 mL in both groups. conclusion TVEA can be safely performed for benign and large ovarian tumors. In addition, TVEA offers superior operative efficiency compared to CLA.
ISSN:1028-4559
1875-6263
DOI:10.1016/j.tjog.2017.04.013