Natural Orifice Transluminal Endoscopic Surgery (NOTES) for colon resections--analysis of the first 139 patients of the German NOTES Registry (GNR)
| Autor: | Markus Utech, Norbert Runkel, Kai S. Lehmann, Dirk R. Bulian, W Lamadé, Heinz J. Buhr, Michael Butters, KP Thon, Markus M. Heiss, Rolf Lefering, Jens Burghardt |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Natural Orifice Endoscopic Surgery medicine.medical_specialty Colon Diverticulitis Colonic German Young Adult Postoperative Complications Colon Sigmoid Ileum Internal medicine Germany Published Database medicine Humans Registries Intraoperative Complications Cecum Colectomy Aged Aged 80 and over business.industry General surgery Gastroenterology Natural orifice transluminal endoscopic surgery Hepatology Diverticulitis Middle Aged medicine.disease language.human_language Surgery Transvaginal cholecystectomy Colonic Neoplasms language Colitis Ulcerative Female business |
| Zdroj: | International journal of colorectal disease. 29(7) |
| ISSN: | 1432-1262 |
| Popis: | The German NOTES registry (GNR) is the largest published database for natural orifice transluminal endoscopic surgery (NOTES) worldwide. Although transvaginal cholecystectomy is the most frequent procedure in the GNR, the number of colorectal resections is increasing. The objective of this study was to analyze the first 139 colonic procedures of the GNR.All colonic procedures from the GNR were analyzed regarding patient- and therapy-related parameters. A multivariate analysis was conducted for transvaginal sigmoid resections regarding procedural time, hospital stay, conversion rate, and rate of complications.From October 2008 to January 2013, 139 colon NOTES procedures (12 male, 127 female) were registered. Main diagnoses were sigmoid diverticulitis (85.6 %), colon carcinoma (9.4 %), and ulcerative colitis (3.6 %). Sigmoid resections (87.1 %), proctocolectomies (3.6 %), right-sided resections (2.9 %), left-sided resections (3.6 %), segmental resections (2.2 %), and 1 ileocecal resection (0.7 %) were performed. All procedures were conducted in transvaginal (87.8 %) or transrectal (12.2 %) hybrid technique, with a median of 3 percutaneous trocars. Conversions to laparoscopic technique were necessary in 3.6 % (none to conventional technique). Intraoperative complications were recorded in 2.9 % and postoperative complications in 12.2 %. The institutional case number in transvaginal sigmoid resections correlated negatively with procedural time (p = 0.041) and the number of percutaneous trocars (p = 0.002).The analysis of the first 139 colon NOTES operations of the GNR shows the feasibility of co on operations in hybrid technique, especially for transvaginal sigmoid resection as the most frequent procedure. |
| Databáze: | OpenAIRE |
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