دورية أكاديمية
أعرض في EDS

Vaginal natural orifice transvaginal endoscopic surgery (vNOTES) for benign ovarian cysts is safe and feasible in same-day discharge: a retrospective cohort study.

التفاصيل البيبلوغرافية
العنوان: Vaginal natural orifice transvaginal endoscopic surgery (vNOTES) for benign ovarian cysts is safe and feasible in same-day discharge: a retrospective cohort study.
المؤلفون: Wang L; Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China., Ge H; Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China., Xiong L; Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.; School of Medicine, University of Electronic Science and Technology of China, Chengdu, China., Xie A; School of Medicine, University of Electronic Science and Technology of China, Chengdu, China., Wu X; School of Medicine, University of Electronic Science and Technology of China, Chengdu, China., Huang J; Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China., Liu T; Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China., Li X; Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China., Jia Y; Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China., Liao J; Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China., Wang H; Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China., Lin Y; Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. Linlinyhcd2011@163.com.; School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. Linlinyhcd2011@163.com., Gan X; Department of Gynecology and Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. Amandine2021@163.com.; School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. Amandine2021@163.com.
المصدر: BMC women's health [BMC Womens Health] 2024 Sep 14; Vol. 24 (1), pp. 514. Date of Electronic Publication: 2024 Sep 14.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101088690 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6874 (Electronic) Linking ISSN: 14726874 NLM ISO Abbreviation: BMC Womens Health Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, 2001-
مواضيع طبية MeSH: Ovarian Cysts*/surgery , Natural Orifice Endoscopic Surgery*/methods , Vagina*/surgery , Feasibility Studies*, Humans ; Female ; Adult ; Retrospective Studies ; Middle Aged ; Ambulatory Surgical Procedures/methods ; Length of Stay/statistics & numerical data ; Patient Discharge/statistics & numerical data ; Operative Time
مستخلص: Background: Advances in minimally invasive surgery and the development of Enhanced Recovery After Surgery (ERAS) have favored the spread of day-surgery programs. Even though Vaginal natural orifice transvaginal endoscopic surgery (vNOTES) is accepted as an innovative treatment for benign ovarian cysts that is rapidly gaining recognition worldwide, the safety and feasibility of same-day surgery (SDS) have yet to be established.
Objective: This study aimed to evaluate the safety and feasibility of day surgery compared to inpatient surgery of patients undergoing vNOTES for benign ovarian cysts by determining perioperative outcomes.
Materials and Methods: The study consisted of 213 patients who underwent vNOTES for ovarian cystectomy at a single institution from January 2020 to November 2022. Based on the hospital stay, patients were classified into the same-day surgery group (SDSG) and the inpatient surgery group (ISG); after data processing and screening considering the balance of the two groups, SDSG has 83 samples(n = 83), and ISG has 113 samples(n = 113). The patient's demographic characteristics and follow-up data were collected during the perioperative period by doctors and nurses for medical tracking and analysis purposes and 1-month postoperatively by doctors in charge of their operation. Independent sample t-tests were performed to verify if there was any major difference between these two groups for continuous data like age, BMI, and cyst diameter, and Pearson's chi-squared tests were used to test whether there was a major difference between these two groups for categorical data like cyst count, abdominal surgery history and whether their cyst is bilateral ovarian cysts or not. The association between exhaust time and postoperative characteristics and the association between levels of pain and postoperative characteristics were further analyzed to unveil the confounding factors contributing to the same-day discharge method's quick recovery nature.
Results: Upon performing propensity score matching, 196 patients were finally enrolled in this study for the matched comparison, including 83(42.3%) patients in the SDSG and 113(57.7%) patients in the ISG. There was no statistical difference between the two groups in terms of duration of operation (85.0 ± 41.5 min vs. 80.5 ± 33.5 min), estimated blood loss (27.7 ± 28.0 ml vs. 36.3 ± 33.2 ml), preoperative hemoglobin levels (128.8 ± 13.2 g/L vs. 128.6 ± 14.0 g/L), postoperative hemoglobin difference at 24 h (16.5 ± 15.4 g/L vs. 19.3 ± 9.1 g/L), pelvic adhesions (42 (50.6%) vs. 47 (41.6%)), and postoperative complications (7(8.4%) vs. 4(3.5%)). The SDSG group showed less time of feeding/off-bed/exhaust/urination after surgery, shorter hospitalization duration, a lower postoperative 6-hour pain score, and a lower incidence of analgesic drug use. Multiple linear regression analysis showed that advancing the time of postoperative off-bed activity and feeding reduced the postoperative exhaust time by 0.34 (95% CI: 0.185-0.496, 0.34 h, p < 0.001) and 0.299(95% CI: 0.158-0.443, 0.229 h, p = 0.036) hours. In addition, Ordinal logistic regression revealed a correlation between pain scores and bilaterality of cyst, increasing about 25.98 times the risk of pain levels when ovarian cysts are bilateral (OR: 26.98, 95% CI: 1.071-679.859, P = 0.045).
Conclusion: In this pilot study, same-day discharge after vaginal natural orifice transvaginal endoscopic ovarian cystectomy is safe and feasible. The vNOTES for ovarian cystectomy combined with the same-day discharge shorten the exhaust time and duration of hospitalization, reduce postoperative pain, and lower the use incidence of analgesic drugs.
(© 2024. The Author(s).)
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معلومات مُعتمدة: 2022NSFSC0815 Natural Science Foundation of Sichuan Province; 2022NSFSC0815 Natural Science Foundation of Sichuan Province; 2022NSFSC0815 Natural Science Foundation of Sichuan Province; 2022NSFSC0815 Natural Science Foundation of Sichuan Province; 2022NSFSC0815 Natural Science Foundation of Sichuan Province; 2022NSFSC0815 Natural Science Foundation of Sichuan Province; 2022NSFSC0815 Natural Science Foundation of Sichuan Province; 2022NSFSC0815 Natural Science Foundation of Sichuan Province; 2022NSFSC0815 Natural Science Foundation of Sichuan Province; YC2021004 Yingcai Scheme, Chengdu Women's and Children's Central Hospita; YC2021004 Yingcai Scheme, Chengdu Women's and Children's Central Hospita; YC2021004 Yingcai Scheme, Chengdu Women's and Children's Central Hospita; YC2021004 Yingcai Scheme, Chengdu Women's and Children's Central Hospita; Q21060 Youth Innovation Foundation of Sichuan Provincial Medical; Q21060 Youth Innovation Foundation of Sichuan Provincial Medical
فهرسة مساهمة: Keywords: Benign ovarian cysts; Enhanced recovery after surgery (ERAS); Same-day surgery (SDS); Vaginal natural orifice transvaginal endoscopic surgery (vNOTES)
تواريخ الأحداث: Date Created: 20240913 Date Completed: 20240914 Latest Revision: 20240916
رمز التحديث: 20240916
مُعرف محوري في PubMed: PMC11401259
DOI: 10.1186/s12905-024-03352-0
PMID: 39272028
قاعدة البيانات: MEDLINE
الوصف
تدمد:1472-6874
DOI:10.1186/s12905-024-03352-0