{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:26:04Z","timestamp":1767165964697,"version":"build-2238731810"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"vor","delay-in-days":219,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["201940284"],"award-info":[{"award-number":["201940284"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p>\n                    <jats:italic>Objective<\/jats:italic>\n                    . To compare hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (VNOTES) versus transumbilical laparoscopic single\u2010site surgery (LESS) as a minimal invasive technique.\n                    <jats:italic>Materials and Method<\/jats:italic>\n                    . The women undergoing hysterectomy for benign diseases by VNOTES and LESS from January 2020 to June 2021 in a tertiary hospital in Shanghai were retrospectively analyzed.\n                    <jats:italic>Results<\/jats:italic>\n                    . 361 women were included in our study, with 228 in the VNOTES groups, 129 in the LESS groups, and 4 conversions from VNOTES to LESS technique. The length of a VNOTES hysterectomy was shorter than that of LESS (80.76\u2009min versus 112.09\u2009min; MD \u201031.34\u2009min; 95% CI \u201040.24 to \u201022.43\u2009min;\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001). VNOTES hysterectomy has a quicker gas passage by the anus (18.80 versus 36.49 hours, MD \u201017.68 hours, 95% CI \u201020.23 to \u201015.14 hours,\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001) and associated with a shorter length of hospital stay (2.31 versus 3.77 days, MD \u20101.46 days, 95% CI \u20101.75 to \u20101.17 days,\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001), while with no increase in blood loss during the operation (median 50 versus 50\u2009ml,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.25). Besides, the VAS pain score in the 24\n                    <jats:sup>th<\/jats:sup>\n                    hour after the operation was lower (median 0 versus 0.5,\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001) in the VNOTES group. Four unique phases of the learning curve were identified using cumulative analysis: the mean operation time of phase I was 82.81 \u00b1 31.45\u2009min (the initial learning curve of 43 cases), phase II was 72.48 \u00b1 23.66\u2009min (the acquisition of command of 91 cases), phase III was 103.77 \u00b1 45.69\u2009min (the further learning of 26 cases), and phase IV was 73.18 \u00b1 26.89\u2009min (postlearning in 68 cases).\n                    <jats:italic>Conclusions<\/jats:italic>\n                    . VNOTES is noninferior to LESS as a new minimal invasive procedure for hysterectomy, which also allows patients a faster recovery from surgery and to suffer less pain, and its efficiency and feasibility in large uterine need further exploring.\n                  <\/jats:p>","DOI":"10.1155\/2022\/8246761","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T22:05:09Z","timestamp":1659996309000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["[Retracted] Hysterectomy by Transvaginal Natural Orifice Transluminal Endoscopic Surgery versus Transumbilical Laparoscopic Single\u2010Site Surgery: A Single\u2010Center Experience from East 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