Perioperative outcomes of and predictors for conversion from transvaginal natural orifice transluminal endoscopic tubal surgeries: A retrospective cohort study of 619 patients

Abstract

AbstractObjectiveTo assess the perioperative outcomes of vNOTES tubal surgeries and to identify predictors of surgical conversion.MethodsA single‐center retrospective cohort study was performed on 619 patients who underwent vNOTES tubal surgeries in our institute from December 2018 to October 2021. Patients were categorized into “converted” or “non‐converted” groups based on whether conversion occurred. t‐test and χ2 test were performed on demographic and clinicopathologic data to compare their perioperative outcomes. Logistic regression was built to identify predictors for surgical conversions.ResultsThe conversion and complication rates of the vNOTES tubal surgeries in the present study were 3.07% and 4.85%, respectively. The “converted group” has a significantly higher percentage of patients with severe pelvic adhesions (9/19 [47.4%]) and pelvic endometriosis (2/19 [10.5%]), which significantly predicates surgical conversion. The “converted group” also had a longer duration of surgery (140.94 ± 88.73 min, P = 0.002) and an increased proportion of “converted from vNOTES” patients experienced more than 50 ml of intraoperative blood loss (7/19 [36.9%]). Four patients had intraoperative rectal injuries, and no Clavien–Dindo III–V postoperative complications occurred.ConclusionvNOTES tubal surgeries are safe due to low conversion and complication rates. Severe pelvic adhesion and endometriosis are predictors for surgical conversions.