Comparison of laparoscopy and vNOTES in early-stage endometrial cancer

J Obstet Gynaecol Res. 2024 Sep;50(9):1649-1654. doi: 10.1111/jog.16054. Epub 2024 Aug 19.

Abstract

Aim: To compare the demographic, clinical, surgical, histopathological, and oncological outcomes of vNOTES and conventional laparoscopy (CL)for early-stage endometrial cancer.

Methods: A retrospective study was carried out in the Gynecologic Clinic of a tertiary hospital from January 2019 to November 2020. Patient demographic characteristics, surgical outcomes, histopathological characteristics, visual analog scale (VAS) pain scores at postoperative 6th, 12th, and 24th, intra- and postoperative complications, and follow-up results were noted.

Results: A total of 45 patients enrolled, of which 16 underwent CL and 29 were vNOTES. The operative time and decrease in hemoglobin levels were similar for both groups (p = 0.202, p = 0.699). Postoperative hospital stay did not differ between the vNOTES group and the CL group (p = 0.549). VAS pain scores at postoperative 6th, 12th, and 24th h were significantly lower in vNOTES group than in the CL group (p < 0.001). The requirement for additional opioid/narcotic analgesic was lower in the vNOTES group than in the CL group (p = 0.037).

Conclusion: vNOTES may be a safe and feasible option in early-stage endometrial cancer, having less postoperative pain and less requirement of opioid/narcotic analgesic compared with laparoscopy.

Keywords: endometrial cancer; laparoscopy; lymphadenectomy; minimally invasive surgery; transvaginal natural orifice transluminal endoscopic surgery (vNOTES).

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Endometrial Neoplasms* / pathology
  • Endometrial Neoplasms* / surgery
  • Female
  • Humans
  • Laparoscopy* / methods
  • Laparoscopy* / statistics & numerical data
  • Middle Aged
  • Neoplasm Staging
  • Pain, Postoperative / etiology
  • Retrospective Studies