【摘要】 目的 探讨翻转法v-NOTES在子宫肌瘤剔除术中的应用价值，并评估其安全性及有效性。方法 回顾性分析2024年1月至12月在克拉玛依市中心医院妇科行v-NOTES子宫肌瘤剔除术的67例患者临床资料，根据术式分为翻转法v-NOTES组(33例，无生育要求)和传统v-NOTES组(34例),比较两组患者的围手术期指标、术后恢复情况、并发症及生活质量评分(UFS-QOL)。结果 两组患者均顺利完成手术，翻转法v-NOTES组能处理肌瘤位置更高，剔除肌瘤数目更多，且以肌壁间肌瘤为主，但手术操作时间长，术中出血多，术后留置尿管时间长，术后住院时间长，两组差异具有统计学意义(P<0.05),两组患者总体并发症发生率、术后早期下床活动时间、胃肠功能恢复时间及短期疼痛评分方面无显著差异(P>0.05),术后3个月及6个月随访显示，两组患者的症状严重程度(SSS)评分均显著下降(P<0.05),健康相关生活质量(HPQL)评分均显著上升(P<0.05),且组间改善幅度无差异(P>0.05)。结论 翻转法v-NOTES是一种安全、有效的微创术式，扩展了v-NOTES子宫肌瘤剔除术的适应证，能够很好地处理高位子宫肌瘤，术后患者生活质量获得显著改善，为无生育需求的子宫肌瘤患者提供了新的理想手术选择。更多还原

【Abstract】 Objective To explore the application value of the flipping technique v-NOTES in myomectomy and evaluate its safety and efficacy.Methods Clinical data of 67 patients undergoing v-NOTES myomectomy at the Gynecology Department of Karamay Central Hospital between January and December 2024 were retrospectively analyzed. Patients were divided into the flipping technique v-NOTES group(33 cases, no fertility requirements) and the conventional v-NOTES group(34 cases) based on surgical technique. Comparing perioperative indicators, postoperative recovery, complications, and quality of life scores(UFS-QOL) between groups.Results Both groups underwent uneventful procedures. The flipping technique v-NOTES group managed higher-positioned fibroids and removed more lesions, predominantly intramural fibroids. However, it exhibited longer operative times, greater intraoperative blood loss, delayed urinary catheter removal, and longer postoperative hospital stays-all statistically significant differences(P<0.05). No significant differences were observed between groups in overall complication rates, early postoperative ambulation time, gastrointestinal recovery time, or short-term pain scores(P>0.05). At 3-month and 6-month follow-ups, both groups showed significant reductions in symptom severity scores(SSS)(P<0.05) and significant improvements in health-related quality of life(HRQL) scores(P<0.05), with no significant difference in the magnitude of improvement between groups(P>0.05).Conclusion The flipping technique v-NOTES is a safe and effective minimally invasive procedure that successfully expands the indications for v-NOTES technology. It effectively manages high-lying uterine fibroids, resulting in significant postoperative improvements in patients’ quality of life. This approach offers a new ideal surgical option for women with uterine fibroids who have no desire for future pregnancy.更多还原