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Gastrointest Endosc. 2018 Feb;87(2):509-516. doi: 10.1016/j.gie.2017.09.039. Epub 2017 Oct 6.

Laparoscopic cholecystectomy versus transvaginal natural orifice transluminal endoscopic surgery cholecystectomy: results of a prospective comparative single-center study.

Author information

1
The International Translational Medicine and Biomodeling Research team, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia; Institute of Numerical Mathematics, Russian Academy of Sciences, Moscow, Russia; Department of Surgery, Danat Al Emarat Hospital, Abu Dhabi, United Arab Emirates; The New European Surgical Academy (NESA), Berlin, Germany.
2
The International Translational Medicine and Biomodeling Research team, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia; The New European Surgical Academy (NESA), Berlin, Germany; Department of Obstetrics and Gynecology, Ioannina State General Hospital G. Chatzikosta, Ioannina, Greece.
3
Department of Obstetrics and Gynecology, Burjeel Hospital, Abu Dhabi, United Arab Emirates.
4
The International Translational Medicine and Biomodeling Research team, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia; The New European Surgical Academy (NESA), Berlin, Germany; Russian National Research Medical University N. I. Pirogov, Moscow, Russia.
5
The International Translational Medicine and Biomodeling Research team, Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia; The New European Surgical Academy (NESA), Berlin, Germany; ELSAN Hospital Group, Paris, France.
6
Department of Surgery, Danat Al Emarat Hospital, Abu Dhabi, United Arab Emirates.

Abstract

BACKGROUND AND AIMS:

Laparoscopic cholecystectomy (LC) in female individuals has been challenged recently by transvaginal natural orifice transluminal endoscopic surgery cholecystectomy (TVC). TVC has not been widely accepted as a standard procedure, even though it is reported to be a safe and painless alternative to LC. This prospective comparative study aims to not only prove equality of TVC and LC but to underline the advantages of TVC over LC with regard to postoperative pain.

METHODS:

This study presents an analysis of a single-center and single-surgeon study with 226 unselected consecutive cholecystectomies performed as either TVC or LC.

RESULTS:

A total of 226 female patients underwent surgery with either LC (136 cases) or TVC (90 cases). There were no postoperative adverse events. Twenty-two patients (24.2%) in the TVC group indicated 0 (no pain) on a visual analog scale postoperatively, whereas only 5 patients (3.7%) did so in the LC group (P = < .0001). Overall consumption of non-steroidal anti-inflammatory drugs was significantly less (P < .0001; t test) in the TVC group (mean, 1.2 ± 0.11 g) compared with the LC group (mean, 2.1 ± 0.1 g). Twenty-three patients (25.5%) in the TVC group needed no postoperative analgesics at all.

CONCLUSIONS:

TVC is a safe and painless procedure for patients with symptomatic cholelithiasis who are from various ethnic and cultural origins. This benefit, along with an equal safety profile compared with LC, should pave the way for wider application of TVC in women.

PMID:
28993135
DOI:
10.1016/j.gie.2017.09.039
[Indexed for MEDLINE]

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