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Prospective evaluation of transvaginal assisted cholecystectomy

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Abstract

Background

Transvaginal video-assisted cholecystectomy (TVC) has so far not been prospectively evaluated using an internationally recognized health-related quality of life (HRQoL) assessment. We report the results of a prospectively studied cohort of patients with clinical and quality of life data.

Methods

Prospectively controlled study of 128 patients undergoing TVC and 147 patients with conventional laparoscopic cholecystectomy (CLC). Data reported include patient demography, body mass index, anesthetic risk score (ASA), laboratory data, surgical times, length of hospital stay, pain score, analgesic medication used, complications, and quality of life scores using the combined method of SF-36 and GIQoL.

Results

Ninety-five TVC and 96 CLC patients fully completed pre- and postoperative HRQoL questionnaires. Patients with incomplete or missing questionnaires were excluded as well as patients with signs of acute cholecystitis. Differences included cardiovascular comorbidity and previous surgical procedures, but there was no difference in age (p = 0.4), body mass index (p = 0.4), ASA grade (p = 0.4), or preoperative quality of life. No difference was seen in laboratory data, surgical times, or length of hospital stay. Pain score and analgesic medication showed a clear trend and significant differences in favor of TVC. There was no difference in complications. Quality of life and postoperative sexual function did not show any differences between the two groups.

Conclusions

This is the first study to report HRQoL outcomes after TVC using a recognized combined HRQoL assessment method. Although differences do exist in patient comorbidity and previous surgical experience, both groups were comparable. Less postoperative pain and no difference in HRQoL in TVC patients underlines this new procedure as a feasible standard approach in female patients. This study also is the first to differentiate between acute cholecystitis and symptomatic cholecystolithiasis in patients undergoing TVC.

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Disclosures

All authors submitted the Surgical Endoscopy disclosure form individually. Drs D. Borchert, O. Rückbeil and Prof. K. Gellert have no conflicts of interest of financial ties to disclose. M. Federlein and Dr. F. Fritze give lectures organized by HCx Consulting. These lectures are sponsored by the companies Storz, Erbe, Nycomed and Ethicon. M. Federlein received grants for surgical courses from Ethicon and LifeCell. Dr. F. Fritze received grants for taking part in medical conferences from KCI and Novartis. Dr. J. Burghardt lectures in surgical courses on behalf of Covidien and is co-owner of a patent with Storz.

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Authors and Affiliations

  1. Surgery, DRK Hospitals, Berlin, Germany

    Dietmar Borchert

  2. General Surgery, Sana Hospitals, Berlin, Germany

    Matthias Federlein, Oskar Rückbeil, Frauke Fritze & Klaus Gellert

  3. Surgery, Immanuel Hospital, Berlin, Germany

    Jens Burghardt

Authors
  1. Dietmar Borchert
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  2. Matthias Federlein
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  3. Oskar Rückbeil
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  4. Jens Burghardt
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  5. Frauke Fritze
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  6. Klaus Gellert
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Corresponding author

Correspondence to Dietmar Borchert.

Additional information

Dietmar Borchert and Matthias Federlein share first authorship. This publication contributes to the thesis work of M. Federlein. Sana Hospital Berlin is a teaching hospital of the medical faculty Charité, Humboldt University Berlin, Germany.

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Borchert, D., Federlein, M., Rückbeil, O. et al. Prospective evaluation of transvaginal assisted cholecystectomy. Surg Endosc 26, 3597–3604 (2012). https://doi.org/10.1007/s00464-012-2378-1

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  • DOI: https://doi.org/10.1007/s00464-012-2378-1

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