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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Surg+Laparosc+Endosc+Percutan+Tech
2016 ; 26
(5
): 347-353
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Safety Outcomes of NOTES Cholecystectomy Versus Laparoscopic Cholecystectomy: A
Systematic Review and Meta-Analysis
#MMPMID27557339
Peng C
; Ling Y
; Ma C
; Ma X
; Fan W
; Niu W
; Niu J
Surg Laparosc Endosc Percutan Tech
2016[Oct]; 26
(5
): 347-353
PMID27557339
show ga
OBJECTIVE: Natural orifice transluminal endoscopic surgery (NOTES) is an
endoscopic technique whereby surgical interventions can be performed with a
flexible endoscope passed through a natural orifice (mouth, vulva, urethra, anus)
then through a transluminal opening of the stomach, vagina, bladder, or colon.
Although in the early stage of research and development, NOTES has been
clinically applied across the globe, above all the transvaginal cholecystectomy
is among the most frequently performed procedures. In the existing 2 types of
transvaginal routes, the hybrid NOTES cholecystectomy (NC) is more likely to be
accepted. However, there has been controversy regarding the safety outcomes of
hybrid NC in comparison with classical laparoscopic cholecystectomy (LC). The
primary objective of this meta-analysis is to compare the characteristics between
NC and classical LC. MATERIALS AND METHODS: A meta-analysis of eligible studies
comparing NC with classical LC was performed to evaluate the safety outcomes
including wound complications, other postoperative complications and
intraoperative conversion between the 2 groups. RESULTS: Pooling 3 randomized
controlled trials (n=157) and 7 nonrandomized trial (n=593) demonstrated that the
rates of wound complications and other postoperative complications in NC group
did not significantly differ from those of classical LC group [wound
complications: ratio difference (RD)=-0.02, 95% confidence interval (CI) -0.04to
0.01, P=0.23; other postoperative complication: RD=-0.01; 95% CI, -0.03 to 0.02;
P=0.6]. The intraoperative conversion rate in NC groups was higher than that of
LC groups (RD=0.03; 95% CI, 0.01-0.06; P=0.02). CONCLUSIONS: There is no
significate difference between the safety of NC and laparoscope cholecystectomy.
NC is associated with a higher rate of intraoperative conversion when compared
with LC. It is worthy of further promotion and validation in clinical settings.
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