Meta-analysis of hybrid natural-orifice transluminal endoscopic surgery <i>versus</i> laparoscopic surgery

Steinemann, Daniel C.; Müller, Philip C.; Probst, Pascal; Schwarz, Anne-Catherine; Büchler, Markus W.; Linke, Georg R.

doi:10.1002/bjs.10564

Cited by 31 publications

(24 citation statements)

References 60 publications

(226 reference statements)

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“…The findings of the HALON trial demonstrating less postoperative pain after vNOTES are consistent with the results of a recently reported systematic review including six RCTs and 21 non‐randomised trials in 2186 patients undergoing abdominal surgery …”

Section: Discussionsupporting

confidence: 88%

Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day‐care procedure: a randomised controlled trial

Baekelandt

Mulder

Roy

et al. 2018

BJOG

143

170

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Objective To compare hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) versus total laparoscopic hysterectomy (TLH) as a day-care procedure.Design Parallel group, 1:1 randomised single-centre single-blinded trial, designed as a non-inferiority study with a margin of 15%.Setting Belgian teaching hospital.Population Women aged 18-70 years scheduled to undergo hysterectomy for benign indications.Methods Randomisation to TLH (control group) or vNOTES (experimental group). Stratification according to uterine volume. Blinding of participants and outcome assessors.Main outcome measures The primary outcome was hysterectomy by the allocated technique. We measured the proportion of women leaving within 12 hours after hysterectomy and the length of hospital stay as secondary outcomes. Results We randomly assigned 70 women to vNOTES (n = 35) or TLH (n = 35). The primary endpoint was always reached in both groups: there were no conversions. We performed a sensitivity analysis for the primary outcome, assuming one conversion in the vNOTES group and no conversions in the TLH group: the onesided 95% upper limit for the differences in proportions of conversion was estimated as 7.5%, which is below the predefined non-inferiority margin. More women left the hospital within 12 hours after surgery after vNOTES: 77 versus 43%, difference 34% (95% CI 13-56%), P = 0.007. The hospital stay was shorter after vNOTES: 0.8 versus 1.3 days, mean difference À0.5 days, (95% CI À0.98 to À0.02), P = 0.004.Conclusions vNOTES is non-inferior to TLH for successfully performing hysterectomy without conversion. Compared with TLH, vNOTES may allow more women to be treated in a day-care setting.Keywords Core outcome set, day-care surgery, laparoscopic hysterectomy, randomised controlled trial, vNOTES.Tweetable abstract RCT: vNOTES is just as good as laparoscopy for successful hysterectomy without conversion but allows more day-care surgery.Please cite this paper as: Baekelandt JF, De Mulder PA, Le Roy I, Mathieu C, Laenen A, Enzlin P, Weyers S, Mol BWJ, Bosteels JJA. Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day-care procedure: a randomised controlled trial. BJOG 2019;126:105-113.

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Section: Discussionsupporting

confidence: 88%

Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day‐care procedure: a randomised controlled trial

Baekelandt

Mulder

Roy

et al. 2018

BJOG

143

170

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“…NOTES technique was described many years ago, initially for cholecystectomy and appendectomy 11 . However, the expansion of this technique to the neck area occurred very slowly due to anatomical issues, which made it impossible to create a good working space, and the lack of instruments for adequate dissection and hemostasis.…”

Section: Discussionmentioning

confidence: 99%

Tireoidectomia endoscópica transoral por acesso vestibular (TOETVA): experiência inicial no Brasil.

Tesseroli¹,

Spagnol

Sanábria

2018

Rev. Col. Bras. Cir.

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RESUMO Objetivo: apresentar a experiência inicial no Brasil com a tireoidectomia transoral endoscópica por abordagem vestibular (TOETVA). Métodos: estudo prospectivo de pacientes submetidos à TOETVA no Serviço de Cirurgia de Cabeça e Pescoço do Hospital Regional do Oeste, Chapecó, Santa Catarina. Foram candidatos para o estudo os pacientes entre 18 e 65 anos de idade, ASA I e II, com volume glandular de até 35cm3e nódulos de até de 4cm. Dados dos pacientes, dos nódulos, tempo cirúrgico, complicações, e tempo de internação foram registrados. Resultados: nove pacientes foram operados entre maio de 2017 e abril de 2018. Todos eram mulheres, com idades entre 33 e 64 anos. O tamanho do nódulo variou de 1cm a 4cm. Dois pacientes eram portadores de neoplasia maligna e a tireoidectomia total foi feita em oito casos. Sete pacientes tiveram uma internação de apenas um dia. Um paciente sofreu uma complicação menor na pele, mas não ocorreram lesões dos nervos laríngeos recorrentes ou hipoparatireoidismo definitivo. Conclusão: a TOETVA é uma técnica segura para pacientes bem selecionados, com condições favoráveis e com especial preocupação com resultados estéticos.

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“…Jonas et al stated that the potential benefits of transvaginal hybrid NOTES sigmoid resection could be less postoperative pain, faster convalescence, and reduced risk of wound infections and incisional hernia compared to conventional methods [ 16 ]. Steinemann et al also stated that hybrid NOTES reduces postoperative pain and is associated with greater cosmetic satisfaction [ 17 ]. Khan et al revealed that hybrid V-NOTES appendectomy is associated with minimal post-operative pain, shorter healing time, and improved cosmetic outcomes [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Hysterectomy and salpingo-oophorectomy by transvaginal natural orifice transluminal endoscopic surgery (V-NOTES) assisted by an umbilical camera: Case report and new hybrid technique in gynecology

Terzi

Türkay

Uzun

et al. 2018

International Journal of Surgery Case Reports

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Meta-analysis of hybrid natural-orifice transluminal endoscopic surgery versus laparoscopic surgery

Abstract: Hybrid NOTES reduces postoperative pain and is associated with greater cosmetic satisfaction in selected patients.

Cited by 31 publications

References 60 publications

Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day‐care procedure: a randomised controlled trial

Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day‐care procedure: a randomised controlled trial

Tireoidectomia endoscópica transoral por acesso vestibular (TOETVA): experiência inicial no Brasil.

Hysterectomy and salpingo-oophorectomy by transvaginal natural orifice transluminal endoscopic surgery (V-NOTES) assisted by an umbilical camera: Case report and new hybrid technique in gynecology

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