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首页> 外文期刊>Surgical Endoscopy >Transvaginal video-assisted cholecystectomy in clinical practice.
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Transvaginal video-assisted cholecystectomy in clinical practice.

机译：经阴道电视辅助胆囊切除术的临床实践。

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BACKGROUND: Transvaginal video-assisted cholecystectomy with rigid instruments is a new procedure that combines natural orifice surgery (NOS) with classic laparoscopy. This hybrid technique requires conventional laparoscopy via an umbilical incision. To date it is unclear if this procedure is safe and feasible in routine practice. METHODS: We report on a case series of 128 women who consented to transvaginal cholecystectomy. Data, including visual analog scores (VAS), were collected prospectively via a standard digital spreadsheet. Patients completed satisfaction questionnaires within 10 days after discharge from hospital. We report on outcomes, age, body mass index, operating time, complications, pain scores, and patient satisfaction. RESULTS: In 115 (89.8%) patients the procedure was performed as a transvaginal operation. In 11 women (8.6%), we converted to standard laparoscopy, and in 2 cases (1.6%), we converted to an open procedure. Mean age was 52.4 years (range = 23-78 years) and mean body mass index was 27.8 (range = 18.8-42). Mean operating time was 60.6 min (range = 22-110 min). Other procedures were combined with hybrid cholecystectomy in six cases. Complications following transvaginal access included one vaginal bleeding, one perforation of the urinary bladder, and one superficial lesion of the rectum. In one case the hepatic duct had to be stented due to leakage after the procedure via endoscopic retrograde cholangiography. Mean VAS on day 1 was 2.26 (+/- 0.31 SEM) and on day 2 it was 1.53 (+/- 0.35 SEM). In a postoperative questionnaire, 95% of patients indicated that they would recommend this procedure to other patients. CONCLUSIONS: Transvaginal cholecystectomy is a safe and easy-to-learn procedure. Possible complications are different than those of standard laparoscopic procedures. Trauma to the abdominal wall and scarring is minimal. Postoperative pain scores were not different than those of standard laparoscopy and a high percentage of patients are satisfied with the procedure.
机译：背景：经阴道视频辅助胆囊切除术采用硬性器械是一种结合自然口孔手术（NOS）和经典腹腔镜检查的新方法。这种混合技术需要通过脐带切口进行常规腹腔镜检查。迄今为止，尚不清楚该程序在常规实践中是否安全可行。方法：我们报道了128例同意经阴道胆囊切除术的女性的病例系列。数据，包括视觉模拟评分（VAS），是通过标准数字电子表格前瞻性收集的。患者出院后10天内完成了满意度调查表。我们报告结局，年龄，体重指数，手术时间，并发症，疼痛评分和患者满意度。结果：115例（89.8％）患者经阴道手术。在11名女性（8.6％）中，我们转换为标准腹腔镜检查，在2例（1.6％）中，我们转换为开放式手术。平均年龄为52.4岁（范围= 23-78岁），平均体重指数为27.8（范围= 18.8-42）。平均操作时间为60.6分钟（范围= 22-110分钟）。其他手术加混合胆囊切除术6例。经阴道入路后的并发症包括一处阴道出血，一处膀胱穿孔和一处直肠浅表病变。在一种情况下，由于通过内窥镜逆行胆管造影术进行手术后的渗漏，肝导管必须被置入支架。第1天的平均VAS为2.26（+/- 0.31 SEM），第2天的平均VAS为1.53（+/- 0.35 SEM）。在术后调查表中，有95％的患者表示他们会向其他患者推荐这种方法。结论：经阴道胆囊切除术是一种安全且易于学习的方法。可能的并发症不同于标准的腹腔镜手术。腹壁外伤和疤痕极少。术后疼痛评分与标准腹腔镜检查无差异，并且很大一部分患者对该手术感到满意。

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