Comparison of rapid recovery outcomes between vNOTES hysterectomy and laparoscopic hysterectomy: a prospective study

Abstract Background This study was aimed at evaluating the postoperative outcomes of vaginal natural orifice transluminal endoscopic hysterectomy (vNOTEH). Methods This prospective cohort study was conducted for comparing recovery outcomes, the time to first anal exhaust and return-to-work (RTW) tim...

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Main Authors: Ying Tang, Chun-ling Fang, Jun-rong Huang, Xiao-mei Chen, Xin Cai, Jia Wu, Hui-quan Hu, Jun Li, Yue-xi Luo
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-02906-9
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author Ying Tang
Chun-ling Fang
Jun-rong Huang
Xiao-mei Chen
Xin Cai
Jia Wu
Hui-quan Hu
Jun Li
Yue-xi Luo
author_facet Ying Tang
Chun-ling Fang
Jun-rong Huang
Xiao-mei Chen
Xin Cai
Jia Wu
Hui-quan Hu
Jun Li
Yue-xi Luo
author_sort Ying Tang
collection DOAJ
description Abstract Background This study was aimed at evaluating the postoperative outcomes of vaginal natural orifice transluminal endoscopic hysterectomy (vNOTEH). Methods This prospective cohort study was conducted for comparing recovery outcomes, the time to first anal exhaust and return-to-work (RTW) time in vNOTEH versus laparoscopic hysterectomy (LH) groups. Linear regression analysis and cox proportional hazards regression were employed for analyzing the association between the recovery outcomes and surgical procedures. Results Altogether 330 patients were enrolled, with 92 in vNOTEH group whereas 238 in LH group according to the surgical procedure. Among them, 22 patients undergoing vNOTEH and 76 patients receiving LH returned to work. The operation time, the first anal exhaust time, RTW time, postoperative hospitalization of vNOTEH group remarkably decreased relative to LH group (P<0.05). Linear regression analysis indicated that the vNOTES approach was related to the time to first anal exhaust. Besides, Kaplan-Meier curve demonstrated the shorter median time to first anal exhaust in vNOTEH group than that in LH group (48.0 h vs. 69.0 h, P < 0.001). For patients who returned to work, multivariate Cox logistic regression revealed that surgical approach and postoperative hospitalization were significantly related to the RTW time. Furthermore, Kaplan-Meier curve showed that the median RTW time significantly decreased in vNOTEH subgroup relative to that in LH subgroup (2.0 months vs.3.0 months, P = 0.011). Conclusions and relevance vNOTES in women might be advantageous in the earlier recovery of intestinal function and the earlier return to work after hysterectomy compared with laparoscopy. Trial registration This study has been registered at https://www.chictr.org.cn with registration NO. ChiCTR2200063125 on Sep 27, 2022. The minimal postoperative follow up period was 1 month.
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spelling doaj-art-ea254e7d432f44a084e81b448dceb8e62025-08-20T01:48:52ZengBMCBMC Surgery1471-24822025-04-0125111110.1186/s12893-025-02906-9Comparison of rapid recovery outcomes between vNOTES hysterectomy and laparoscopic hysterectomy: a prospective studyYing Tang0Chun-ling Fang1Jun-rong Huang2Xiao-mei Chen3Xin Cai4Jia Wu5Hui-quan Hu6Jun Li7Yue-xi Luo8Department of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical CollegeDepartment of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical CollegeDepartment of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical CollegeDepartment of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical CollegeDepartment of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical CollegeDepartment of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical CollegeDepartment of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical CollegeDepartment of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical CollegeDepartment of Obstetrics and Gynecology, The Affiliated Nanchong Central Hospital of North Sichuan Medical CollegeAbstract Background This study was aimed at evaluating the postoperative outcomes of vaginal natural orifice transluminal endoscopic hysterectomy (vNOTEH). Methods This prospective cohort study was conducted for comparing recovery outcomes, the time to first anal exhaust and return-to-work (RTW) time in vNOTEH versus laparoscopic hysterectomy (LH) groups. Linear regression analysis and cox proportional hazards regression were employed for analyzing the association between the recovery outcomes and surgical procedures. Results Altogether 330 patients were enrolled, with 92 in vNOTEH group whereas 238 in LH group according to the surgical procedure. Among them, 22 patients undergoing vNOTEH and 76 patients receiving LH returned to work. The operation time, the first anal exhaust time, RTW time, postoperative hospitalization of vNOTEH group remarkably decreased relative to LH group (P<0.05). Linear regression analysis indicated that the vNOTES approach was related to the time to first anal exhaust. Besides, Kaplan-Meier curve demonstrated the shorter median time to first anal exhaust in vNOTEH group than that in LH group (48.0 h vs. 69.0 h, P < 0.001). For patients who returned to work, multivariate Cox logistic regression revealed that surgical approach and postoperative hospitalization were significantly related to the RTW time. Furthermore, Kaplan-Meier curve showed that the median RTW time significantly decreased in vNOTEH subgroup relative to that in LH subgroup (2.0 months vs.3.0 months, P = 0.011). Conclusions and relevance vNOTES in women might be advantageous in the earlier recovery of intestinal function and the earlier return to work after hysterectomy compared with laparoscopy. Trial registration This study has been registered at https://www.chictr.org.cn with registration NO. ChiCTR2200063125 on Sep 27, 2022. The minimal postoperative follow up period was 1 month.https://doi.org/10.1186/s12893-025-02906-9HysterectomyvNOTESFirst anal exhaustReturn to workBenign uterus disease
spellingShingle Ying Tang
Chun-ling Fang
Jun-rong Huang
Xiao-mei Chen
Xin Cai
Jia Wu
Hui-quan Hu
Jun Li
Yue-xi Luo
Comparison of rapid recovery outcomes between vNOTES hysterectomy and laparoscopic hysterectomy: a prospective study
BMC Surgery
Hysterectomy
vNOTES
First anal exhaust
Return to work
Benign uterus disease
title Comparison of rapid recovery outcomes between vNOTES hysterectomy and laparoscopic hysterectomy: a prospective study
title_full Comparison of rapid recovery outcomes between vNOTES hysterectomy and laparoscopic hysterectomy: a prospective study
title_fullStr Comparison of rapid recovery outcomes between vNOTES hysterectomy and laparoscopic hysterectomy: a prospective study
title_full_unstemmed Comparison of rapid recovery outcomes between vNOTES hysterectomy and laparoscopic hysterectomy: a prospective study
title_short Comparison of rapid recovery outcomes between vNOTES hysterectomy and laparoscopic hysterectomy: a prospective study
title_sort comparison of rapid recovery outcomes between vnotes hysterectomy and laparoscopic hysterectomy a prospective study
topic Hysterectomy
vNOTES
First anal exhaust
Return to work
Benign uterus disease
url https://doi.org/10.1186/s12893-025-02906-9
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