Clinical efficacy of vaginal natural orifice transluminal endoscopic surgery for total hysterectomy in large uteri:a retrospective cohort study
GUO Fang
LI Wei
LIU Li
HU Xueyan
ZHENG Beibei
ZHANG Yuyang
CHEN Xinyan
Abstract：Objective To compare the clinical efficacy of vaginal natural orifice transluminal endoscopic surgery(vNOTES)and traditional laparoscopic surgery(LAP)for total hysterectomy in large uteri,and to explore the clinical application value of vNOTES.Methods A retrospective analysis was conducted on patients who underwent total hysterectomy for benign lesions with a uterine mass ≥ 500 g at the Department of Gynecology,Wenzhou People's Hospital from January 2021 to January 2023.Patients were divided into vNOTES group(n=56)and LAP group(n=58).The general data,operative time,intraoperative blood loss,postoperative pain scores,hospital stay,postoperative complications,and related functional recovery were compared between the two groups.Results No significant differences were observed in baseline characteristics between the two groups.The vNOTES group demonstrated significantly shorter operative time[(157.31±31.73)min vs(178.37±47.68)min,P=0.007],reduced time to first postoperative flatus[(22.15±5.84)h vs(30.00±8.75)h,P=0.001],shorter hospital stay[(3.05±0.49)d vs(4.33±1.27)d,P=0.001],and lower postoperative pain scores[(1.33±1.36) vs(3.96±1.18),P=0.001)compared to the LAP group.No significant differences were found in intraoperative blood loss,postoperative complication rates,and functional recovery between the two groups.Conclusion vNOTES significantly shortens operative time and hospital stay while reducing postoperative pain scores in total hysterectomy for large uteri,aligning with the concept of enhanced recovery after surgery.It is a promising technique worthy of clinical promotion.
Keywords：laparoscopic surgeryvaginal natural orifice transluminal endoscopic surgeryenhanced recovery after surgerylarge uterustreatment efficacypostoperative complications
Publication Date：2025-05-31
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：5( 650-654 )