ArticleBMC surgery2025
Retroperitoneal vNOTES approach in early-stage endometrial cancer: a feasibility cohort with a contemporaneous laparoscopic comparison.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Mid-Term Oncological Outcomes of Vaginal Natural Orifice Transluminal Endoscopic Surgery Compared with Total Laparoscopic Hysterectomy for Early-Stage Endometrial Cancer: A Single-Center Retrospective Study.Journal of clinical medicine · 2026Article
- Surgical approach selection and perioperative-pathological characteristics in endometrial cancer: a retrospective observational study.Frontiers in medicine · 2026Article
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed to assess the feasibility, safety, and perioperative outcomes of the retroperitoneal vaginal natural orifice transluminal endoscopic surgery (vNOTES) approach for surgical staging in patients with early-stage endometrial cancer. A secondary objective was to compare perioperative and short-term results with those achieved using conventional laparoscopy performed by the same surgical team. MATERIALS AND
methodsBetween June 2023 and June 2024, a retrospective study was conducted on 98 patients who underwent surgical staging for early-stage endometrial cancer. Patients were allocated to one of two groups: the vNOTES group (n = 49), who underwent retroperitoneal sentinel lymph node (SLN) biopsy, hysterectomy, and bilateral salpingo-oophorectomy (BSO); and the laparoscopic group (n = 49), who underwent the same procedures via a conventional laparoscopic approach. Demographic, surgical, and pathological parameters, as well as short-term follow-up outcomes, were compared between the two groups.
resultsThe median operative time was significantly shorter in the vNOTES group than in the laparoscopic group (102 vs. 115 min, p < 0.001). SLN detection rates were identical between the groups (97.9% each). Postoperative pain scores on the Visual Analog Scale (VAS) were significantly lower in the vNOTES group at both 6 h (median 3 vs. 5) and 24 h (median 1 vs. 3) (p < 0.001 for both). Patients in the vNOTES group achieved earlier mobilization (median 5 vs. 6 h, p < 0.001) and had a shorter hospital stay (median 2 vs. 3 days, p < 0.001). The incidence of major complications did not differ significantly between the groups, and no recurrences were observed during a median follow-up period of 12 months.
conclusionThe retroperitoneal vNOTES approach appears to be a feasible and safe technique for the surgical staging of early-stage endometrial cancer, providing perioperative benefits including shorter operative time, reduced postoperative pain, and faster recovery. The comparative findings with conventional laparoscopy should be interpreted as exploratory and require validation in larger prospective studies. Oncologic outcomes remain short-term and should be confirmed through long-term follow-up.
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