Comparative efficacy of vNOTES and LESS in the management of benign uterine lesions in obese patients
LI Wenyuan
WEI Min
HAN Jie
LI Ruifeng
WANG Zhen
LI Hailan
XU Jing
JIN Dongmei
XU Lingyan
PENG Rong
ZHANG Yan
SUN Xinhua
Abstract：Objective To compare the outcomes of transvaginal natural orifice transluminal endoscopic surgery(vNOTES)and laparoendoscopic single-site surgery(LESS)for total uterine excision in obese patients with benign uterine lesions,and to investigate the utility of vNOTES in this patient population.Methods A total of 100 obese patients(BMI>28.0 kg/m2)diagnosed with benign uterine lesions requiring total uterine and bilateral salpingectomy between January 2022 and January 2023 were included in this study.They were randomly assigned to two groups:the LESS group(n=51)and the vNOTES group(n=49).Patient demographics,surgical duration,intraoperative blood loss,changes in hemoglobin levels,pain scores,time to first flatus postoperatively,length of hospital stay,pelvic floor function,sexual quality of life,and postoperative complications were compared between the two groups.Results The two groups did not show any statistically significant differences in terms of blood loss,pre-and postoperative hemoglobin changes,pelvic floor function,sexual quality of life,or postoperative complications(P>0.05).However,the vNOTES group exhibited shorter surgical durations,time to first flatus postoperatively,and length of hospital stay compared to the LESS group(P<0.05).Additionally,the vNOTES group demonstrated lower intraoperative pain scores than the LESS group.(P<0.05).Conclusions In obese patients with benign uterine lesions,vNOTES total uterine excision surgery demonstrated shorter surgical durations and postoperative hospital stays,lower postoperative pain scores,and better adherence to the principles of en-hanced recovery after surgery(ERAS),indicating its potential for broader application.
Keywords：transvaginal natural orifice transluminal endoscopic surgerylaparoendoscopic single-site surgeryobesitybenign uterine lesions
Publication Date：2024-11-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 3184-3189 )