Application of transvaginal natural orifice transluminal endoscopic surgery in pelvic organ prolapse

LIU Xin-hua; LIU Shuang; CHENG Ping; HU Jin-ju

doi:10.11659/jjssx.03E025039

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Application of transvaginal natural orifice transluminal endoscopic surgery in pelvic organ prolapse

Clinical Research | 更新时间：2025-12-22

- Application of transvaginal natural orifice transluminal endoscopic surgery in pelvic organ prolapse
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 12, Pages: 1082-1086(2025)
- 作者机构：
  
  1.乌鲁木齐友爱医院生育技术服务科，新疆乌鲁木齐 830000
  2.乌鲁木齐友爱医院妇科，新疆乌鲁木齐 830000
  3.新疆医科大学第二附属医院妇科，新疆乌鲁木齐 830000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.03E025039
  CLC： R711
- Received：06 March 2025，
  
  Published：25 December 2025
- 稿件说明：
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刘新华,刘爽,程萍等.经阴道自然腔道内镜手术在盆腔器官脱垂中的应用[J].局解手术学杂志,2025,34(12):1082-1086.

LIU Xin-hua,LIU Shuang,CHENG Ping,et al.Application of transvaginal natural orifice transluminal endoscopic surgery in pelvic organ prolapse[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(12):1082-1086.
刘新华,刘爽,程萍等.经阴道自然腔道内镜手术在盆腔器官脱垂中的应用[J].局解手术学杂志,2025,34(12):1082-1086. DOI： 10.11659/jjssx.03E025039.

LIU Xin-hua,LIU Shuang,CHENG Ping,et al.Application of transvaginal natural orifice transluminal endoscopic surgery in pelvic organ prolapse[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(12):1082-1086. DOI： 10.11659/jjssx.03E025039.

摘要

目的

探究经阴道自然腔道内镜手术(V-NOTES)在盆腔器官脱垂患者中的应用效果。

方法

选择2021年1月至2024年4月在乌鲁木齐友爱医院妇科住院治疗的盆腔器官脱垂患者120例，将其随机分为观察组和对照组，各60例。观察组患者接受V-NOTES治疗，对照组患者接受多孔腹腔镜手术治疗。对比2组患者通道建立时间、手术时间、术中出血量、盆腔粘连情况、有无输血、术后48 h肛门排气情况、术后1 d及2 d伤口疼痛程度、术后止痛剂使用情况、术后住院时间、有无发热等情况。术后1个月、3个月及6个月分别通过盆腔器官脱垂定量分期法（POP-Q）、患者全身状况改善问卷（PGI-I）、盆底功能障碍问卷（PFDI-20）和盆底障碍影响简易问卷7（PFIQ-7）评价患者客观疗效、主观疗效和盆底症状对患者的影响。

结果

2组患者通道建立时间、手术时间、术中出血量、盆腔粘连情况比较，差异均无统计学意义(

0.05)。观察组术后48 h肛门排气患者比例显著高于对照组(

0.05)，术后使用止痛剂患者比例显著低于对照组(

0.05)。2组患者术后1个月、3个月、6个月、1年的客观有效率比较，差异均无统计学意义(

0.05)。术后6个月、1年观察组患者PGI-I评分、PFDI-20评分、PFIQ-7评分均显著低于对照组(

0.05)。

结论

V-NOTES与多孔腹腔镜手术治疗女性盆腔脏器脱垂患者均有良好效果，且V-NOTES术后患者肛门排气更早，疼痛更轻，主观感受及长期盆底功能恢复情况更好。

Abstract

Objective

To investigate the application effect of transvaginal natural orifice transluminal endoscopic surgery （V-NOTES） in patients with pelvic organ prolapse.

Methods

A total of 120 patients with pelvic organ prolapse who were hospitalized in the Gynecology Department of Urumqi Youai Hospital from January 2021 to April 2024 were selected and randomly divided into the observation group and the control group， with 60 cases in each group. Patients in the observation group received V-NOTES， while those in the control group underwent multi-port laparoscopic surgery. The time of access establishment， operation time， intraoperative blood loss， pelvic adhesion status， blood transfusion requirement， anal exhaust status 48 hours after surgery， the degree of wound pain 1 day and 2 days after surgery， postoperative analgesic use， postoperative hospital stay， and fever occurrence of patients between the two groups were compared. At 1 month， 3 months， 6 months， and 1 year after surgery， the pelvic organ prolapse quantification （POP-Q）， patient global impression of improvement （PGI-I）， pelvic floor distress inventory-short form 20 （PFDI-20）， and pelvic floor impact questionnaire-short form 7 （PFIQ-7） were used to evaluate objective efficacy， subjective efficacy， and the impact of pelvic floor symptoms on patients， respectively.

Results

There was no statistically significant difference in time of access establishment， operation time， intraoperative blood loss， or pelvic adhesion status between the two groups （

0.05）. The proportion of patients with anal exhaust within 48 hours after surgery in the observation group was significantly higher than that in the control group （

0.05）， and the proportion of patients using postoperative analgesics was signifi

cantly lower than that in the control group （

0.05）. No statistically significant differences were found in the objective effective rates between the two groups at 1 month， 3 months， 6 months， or 1 year after surgery （

0.05）. At 6 months and 1 year after surgery， the PGI-I score， PFDI-20 score， and PFIQ-7 score in the observation group were significantly lower than those in the control group （

0.05）.

Conclusion

Both V-NOTES and multi-port laparoscopic surgery have good effects in the treatment of female pelvic organ prolapse. V-NOTES is associated with earlier postoperative anal exhaust， milder pain， better subjective feelings， and superior long-term pelvic floor function recovery in patients.

关键词

Keywords

references

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