Raw Dataset (VNOTES vs LS chromopertubation)

Background: As vaginal natural orifice transluminal endoscopic surgery (vNOTES) is gaining momentum and consolidating its position in minimally invasive surgery for various benign gynecologic conditions, we aimed to investigate the feasibility, acceptability and safety of vNOTES chromopertubation by comparing laparoscopic chromopertubation in women with suspected tubal factor or unexplained infertility Methods: Women who underwent vNOTES or laparoscopic chromopertubation between January 2022 and June 2024 were retrospectively reviewed. After applying exclusion criteria, a total of 58 eligible patients were identified and analyzed. The primary outcomes were surgical complications, overall satisfaction with the procedure and postoperative pain, while the secondary outcomes were the duration of the procedure and the participants' postoperative experience of sexual discomfort or pain during intercourse. Results: The women who underwent vNOTES had a significantly higher body-mass index (34.9±6.79 vs. 31.76±5.37, p=0.020). No complications occurred in either surgical arm. Compared to laparoscopy, vNOTES was associated with significantly lower 6- and 12-hour postoperative visual analogue scale (VAS) scores for pain (0.035 and <0.001, respectively), while there were no significant differences in analgesic requirements and the preoperative and postoperative 6-week Female Sexual Function Index (FSFI) pain domain scores were comparable. The changes in pre- and postoperative FSFI pain domain scores also showed no statistically significant difference between the groups (p=0.403). There were no differences in the satisfaction scores and the number of patients who were satisfied with the method (p=0.286 and 0.110 respectively). Conclusions: v-NOTES chromopertubation is an effective, safe and feasible alternative to laparoscopy for chromopertubation, which also increases operability in obese women and ultimately meets esthetic requirements with less postoperative pain and comparable effects on female sexual life. Larger, multicenter, prospective studies are needed to quantify and determine the safety and broad applicability of vNOTES chromopertubation.

背景：随着经阴道自然腔道内镜手术（vaginal natural orifice transluminal endoscopic surgery, vNOTES）在各类良性妇科疾病的微创手术领域不断发展并巩固其地位，本研究旨在通过对比腹腔镜下输卵管色素通液术，探究vNOTES输卵管色素通液术应用于疑似输卵管因素不孕或不明原因不孕女性的可行性、可接受性与安全性。

方法：本研究回顾性分析了2022年1月至2024年6月间接受vNOTES输卵管色素通液术或腹腔镜下输卵管色素通液术的女性患者。经排除标准筛选后，最终纳入58例符合条件的患者进行分析。本研究的主要结局指标包括手术并发症、手术整体满意度与术后疼痛情况；次要结局指标则为手术时长，以及受试者术后性交时的生殖道不适或疼痛体验。

结果：接受vNOTES手术的患者体重指数显著更高（34.9±6.79 vs. 31.76±5.37，p=0.020）。两组手术均未出现并发症。与腹腔镜手术组相比，vNOTES组患者术后6小时及12小时的疼痛视觉模拟评分法（visual analogue scale, VAS）评分显著更低（分别为p=0.035与p<0.001）；但两组在镇痛药物使用需求上无显著差异，且术前及术后6周的女性性功能指数（Female Sexual Function Index, FSFI）疼痛领域评分均无显著差异。两组术前与术后FSFI疼痛领域评分的变化幅度也无统计学差异（p=0.403）。两组的满意度评分以及对手术方式满意的患者人数均无显著差异（分别为p=0.286与p=0.110）。

结论：vNOTES输卵管色素通液术是腹腔镜下输卵管色素通液术的有效、安全且可行的替代方案，其可提升肥胖女性的手术可操作性，且术后疼痛更轻，对女性性生活的影响与腹腔镜手术相当，同时满足美学需求。未来仍需开展大样本、多中心的前瞻性研究，以量化并明确vNOTES输卵管色素通液术的安全性与广泛适用性。