{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T13:23:53Z","timestamp":1769088233373,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"8-9","license":[{"start":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T00:00:00Z","timestamp":1694390400000},"content-version":"vor","delay-in-days":41,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the effectiveness and safety of transgastric and transrectal pure natural orifice transluminal endoscopic surgery (NOTES) for cholecystolithotomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center retrospective comparative study of consecutive patients who underwent pure NOTES for either\u00a0transrectal or transgastric gallbladder\u2010preserving cholecystolithotomy between September 2017 and April 2020. Patients with symptomatic cholelithiasis were assigned for transrectal or transgastric NOTES based on the patients\u2019 choice. Treatment success, postoperative pain, peritonitis, time to resume normal diet, and duration of hospitalization were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The technical success rate was 100%. Forty\u2010eight patients underwent successful NOTES cholecystolithotomy via the transrectal (n\u2009=\u200926) or transgastric route (n\u2009=\u200922). One (3.8%) patient in the transrectal NOTES group experienced postoperative abdominal pain compared to 6 (27.3%) in the transgastric NOTES group (<jats:italic>P<\/jats:italic>\u2009=\u20090.04). Fever and bile peritonitis developed in one (3.8%) patient in the transrectal NOTES group versus 8 (36.4%) in the transgastric NOTES group (<jats:italic>P<\/jats:italic>\u2009=\u20090.005). A postoperative fluid diet was commenced at 6\u2009h with the transrectal approach versus on day 3 for the transgastric NOTES group. The mean postoperative hospitalization for transrectal and transgastric NOTES groups was 4.5 days versus 7\u2009days (<jats:italic>P<\/jats:italic>\u2009=\u20090.001). Three patients in the transgastric NOTES group developed postoperative gastric fistula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Transrectal NOTES has advantages over transgastric NOTES, including preserved spatial orientation, relatively easier removal of specimens, early food intake, shorter hospitalization, fewer postoperative complications and less pain. Multicenter clinical trials with long\u2010term follow\u2010up are needed to confirm the safety and efficacy of both approaches.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.13221","type":"journal-article","created":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T08:52:35Z","timestamp":1692435155000},"page":"491-496","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Transgastric versus transrectal: Which access route is the best for <scp>NOTES<\/scp> gallbladder\u2010preserving gallstone therapy?"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0064-8942","authenticated-orcid":false,"given":"Saif","family":"Ullah","sequence":"first","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8313-4343","authenticated-orcid":false,"given":"Dan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li Xia","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bing Rong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan Province China"},{"name":"State Key Laboratory of Esophageal Cancer Prevention and Treatment Zhengzhou University  Zhengzhou Henan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9710"},{"issue":"1","key":"e_1_2_7_3_1","first-page":"i25","article-title":"Recent advances in natural orifice transluminal endoscopic surgery","volume":"49","author":"Yip HC","year":"2016","journal-title":"Eur J Cardiothorac 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