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Natural orifice transluminal endoscopic surgery-assisted versus laparoscopic ovarian cystectomy (NAOC vs. LOC): a case-matched study

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Abstract

Background

Natural orifice transluminal endoscopic surgery (NOTES) has shown its prospection as a minimally invasive endoscopic surgery. This study aimed to examine the safety and efficacy of combined NOTES and vaginal approach, natural orifice transluminal endoscopic surgery-assisted ovarian cystectomy (NAOC), in the conservative management of benign ovarian tumors.

Methods

Records were reviewed for the 34 consecutive NAOC procedures between May 2011 and March 2014. Age, body mass index, parity, size of the mass, and bilaterality of the mass were used to select comparable patient who had undergone laparoscopic ovarian cystectomy (LOC).

Results

A total of 277 patients were recruited in this study (243 LOCs and 34 NAOCs, respectively). There was no incidence of switching to abdominal laparotomy. Length of operation and length of postoperative stay were significantly greater in the LOC group than in the NAOC group, but total hospital charges were similar in both groups. There was no difference in febrile morbidity between the two groups but more estimated blood loss (EBL) in NAOC group, although EBL was <50 mL in the two groups. Linear correlations of mass size with operating time and EBL existed in LOC group, but not in NAOC group.

Conclusion

NAOC can be safely performed for benign and large ovarian tumors. Besides, NAOC offers a superior operative efficiency compared with LOC.

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Disclosures

Chin-Jung Wang, Pei-Yin Wu, Hsin-Hong Kuo, Hsing-Tse Yu, Chen-Ying Huang, and Hsiao-Jung Tseng have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of Gynecologic Endoscopy, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, 5, Fu-Hsin Street, Kwei-Shan, Taoyuan, Taiwan

    Chin-Jung Wang, Hsin-Hong Kuo, Hsing-Tse Yu & Chen-Ying Huang

  2. Chang Gung University College of Medicine, Kwei-Shan, Taoyuan, Taiwan

    Chin-Jung Wang, Hsin-Hong Kuo, Hsing-Tse Yu & Chen-Ying Huang

  3. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Keelung, Chilung, Taiwan

    Pei-Yin Wu

  4. Biostatistical Center for Clinical Research, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan

    Hsiao-Tseng Tseng

  5. Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan

    Hsiao-Tseng Tseng

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  1. Chin-Jung Wang
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  2. Pei-Yin Wu
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  3. Hsin-Hong Kuo
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  6. Hsiao-Tseng Tseng
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Correspondence to Chin-Jung Wang.

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Wang, CJ., Wu, PY., Kuo, HH. et al. Natural orifice transluminal endoscopic surgery-assisted versus laparoscopic ovarian cystectomy (NAOC vs. LOC): a case-matched study. Surg Endosc 30, 1227–1234 (2016). https://doi.org/10.1007/s00464-015-4315-6

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  • DOI: https://doi.org/10.1007/s00464-015-4315-6

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