Effect of erythrocyte immunity and urinary function in patients undergoing total hysterectomy by transvaginal natural orifice transluminal endoscopic sugery
Sun Binzhou, Huang Li, Zhu Jing
Department of Gynecology, Qinhuangdao Maternal and Child Health Hospital, Hebei, Qinhuangdao 066000, China
Abstract: 【Abstract】 Objective To investigate the effect of transvaginal natural orifice transluminal endoscopic sugery (vNOTES) on erythrocyte immunity and urinary function in patients undergoing total hysterectomy. Method A total of 136 patients undergoing total hysterectomy in Qinhuangdao Maternal and Child Health Hospital from January 2019 to December 2020 were selected and randomly divided into control group and observation group with 68 cases in each group. The control group underwent transumbilical laparoendoscopicsingle-site surgery (TU-LESS), and the observation group underwent vNOTES. Perioperative indexes and complications of the two groups were analyzed. Erythrocyte immunity before and after surgery [forming enhancement rosetterate (FEER), cluster of differentiation 59 (CD59), associated tumor erythrocyte rosette (ATER)], [luteinizing hormone (LH), follicular stimulating hormone (FSH)], [maximum urine flow rate (Qmax), residual urine volume (RUV), bladder compliance], Pelvic floor impact questionnake, short form 7 (PFIQ-7) ,which were compared between the two groups. t test, χ2 test , fisher exact probability method and repeated measure of variance were used for statistical analysis were used as statistical methods. Result The anal exhaust time and defecation time of the observation group were less than those of the control group [(9.3±1.3), (20.2±2.7) h and (15.6±1.2), (30.3±3.6) h, t=28.876, 18.572, all P<0.001]. The24 h visual analogue scale (VAS) of the observation group was lower than that of the control group [(2.9±0.4)vs (3.9±0.4) points, t=14.500, P<0.001]. The serum levels of ATER, FEER and CD59 in the observation group were higher than those in the control group at 3 days after operation [(50.4±2.1) %, (54.7±3.1) %,(4.9±0.6) % and (46.6±2.7) %, (50.4±3.4) %, (4.0±0.7) %, Fintergroup=13.405, 9.334, 11.271, all P<0.05).Qmax of the observation group was higher than that of the control group [(15.5±1.3), (18.0±1.4) ml/s vs(13.4±1.4), (16.7±1.4) ml/s; RUV was lower than that of control group [(15.7±1.3), (10.1±0.6) ml vs(18.9±2.1), (12.7±0.9) ml, Finteraction=15.182, P<0.05 ]; bladder compliance was lower than that of controlgroup [(7.8±0.6), (5.0±0.4) vs (9.1±0.6), (5.9±0.5), Finteraction=9.532, P<0.05]; PFIQ-7 scores were lowerthan those of control group [(1.6±0.2), (1.1±0.1) vs (1.9±0.2), (1.3±0.2) points, Finteraction=11.332, P<0.05)at 1 month and 3 months after surgery. There were no significant difference in the FSH, LH, incidence of complications between the two groups (P>0.05). Conclusion vNOTES-assisted total hysterectomy can relieve pain, shorten the time of anal defecation and exhaust, and have little effect on erythrocyte immunity and urinary function.
2023, Vol. 11 
