The German Registry for Natural Orifice Translumenal Endoscopic Surgery Report of the First 551 Patients
The German Registry for Natural Orifice Translumenal Endoscopic Surgery Report of the First 551 Patients
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DOI：
10.1097/sla.0b013e3181e6240f
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发表时间：
2010-08-01
影响因子：
9
通讯作者：
Buhr, Heinz J.
中科院分区：
文献类型：
--
作者：
Lehmann, Kai S.;Ritz, Joerg P.;Buhr, Heinz J.
目的：分析德国自然口腔内内窥镜手术(NOTES)登记(GNR)前14个月的患者预后。摘要背景资料：NOTES是一种新的外科概念，允许通过自然开口(如口腔、阴道、直肠或尿路)进行无疤痕的腹部手术。GNR被建立为一个全国性的成果数据库，以便在德国监测和安全地引入该技术。方法：GNR是一个可在线访问的自愿数据库。所有在德国进行笔记手术的外科医生都被要求参加登记。GNR记录人口学和治疗学数据以及术后过程数据。结果：551例患者共进行了572个靶器官手术。胆囊切除术占所有NOTES手术的85.3%。所有手术均为女性患者，采用经阴道杂交术。并发症发生率为3.1%，中转开腹或中转开腹占4.9%。在胆囊切除术中，住院病例量、肥胖和年龄对中转率、手术时间、住院时间有显著影响，但对并发症无明显影响。结论：尽管NOTES是最近才推出的，但该技术已经在临床上得到了相当大的应用。经阴道混合笔记指出，即使在肥胖或老年患者中，经阴道胆囊切除术也是一种可行且安全的替代腹腔镜切除术的方法。
Objective: To analyze patient outcome in the first 14 months of the German natural orifice translumenal endoscopic surgery (NOTES) registry (GNR).Summary Background Data: NOTES is a new surgical concept, which permits scarless intra-abdominal operations through natural orifices, such as the mouth, vagina, rectum, or urethra. The GNR was established as a nationwide outcome database to allow the monitoring and safe introduction of this technique in Germany.Methods: The GNR was designed as a voluntary database with online access. All surgeons in Germany who performed NOTES procedures were requested to participate in the registry. The GNR recorded demographical and therapy data as well as data on the postoperative course.Results: A total of 572 target organs were operated in 551 patients. Cholecystectomies accounted for 85.3% of all NOTES procedures. All procedures were performed in female patients using transvaginal hybrid technique. Complications occurred in 3.1% of all patients, conversions to laparoscopy or open surgery in 4.9%. In cholecystectomies, institutional case volume, obesity, and age had substantial effect on conversion rate, operation length, and length of hospital stay, but no effect on complications.Conclusions: Despite the fact that NOTES has just recently been introduced, the technique has already gained considerable clinical application. Transvaginal hybrid NOTES cholecystectomy is a practicable and safe alternative to laparoscopic resection even in obese or older patients.