M. De Oliveira Filho1, P. Onyeji2, S. Queiroz3, A. Altobi5, E. Munhoz Pinsuti6, A. Ayesha7, S. Momplaisir Onyeji2, L.F. Vasques8, M. Chaves Lenzi9, J.R. De Oliveira Filho4 1Medical College of Barbacena, Department Of Surgery, Barbacena, MINAS GERAIS, Brazil 2All Saints University Commonwealth of Dominica, Department Of Surgery, Roseau, Dominica 3State University of Ponta Grossa, Department Of Surgery, Ponta Grossa, PARANÁ, Brazil 4Dr Clementino Fraga Hospital Complex, Department Of Surgery, João Pessoa, PARAÍBA, Brazil 5European University Cyprus, Department Of Surgery, Nicosia, Cyprus 6Our Lady of Grace Hospitals, Department Of Surgery, Curitiba, PARANÁ, Brazil 7Shifa College of Medicine, Department Of Surgery, ISLAMABAD, Pakistan 8Catholic University of Pelotas, Department Of Surgery, Pelotas, RIO GRANDE DO SUL, Brazil 9State University of Rio Grande do Norte, Department Of Surgery, Mossoró, RIO GRANDE DO NORTE, Brazil
Introduction: vNOTES (Natural Orifice Transluminal Endoscopic Surgery) is gaining traction for gynecological procedures, especially in obese patients with a BMI >30. Evaluating blood loss during these procedures is essential for assessing their safety.
Methods: This meta-analysis includes single-arm studies assessing blood loss in vNOTES gynecological surgery for patients with BMI >30. Relevant studies were identified through PubMed, Embase, and Cochrane databases up to July 4, 2024. Data were extracted and assessed per Cochrane guidelines. Mean differences (MDs) with 95% confidence intervals (CIs) were pooled using a random-effects model.
Results: Data from five studies on blood loss in vNOTES gynecological surgery among patients with BMI >30 were synthesized. Bouchez et al. (2023) reported a mean blood loss of 127.80 (SD 302.35), 95% CI [-464.80; 720.40], contributing 0.4% to the analysis. Hurmi et al. (2023) reported 50.00 (SD 147.50), 95% CI [-239.09; 339.09], weighted at 1.7%. Kaya et al. (2021) observed 269.00 (SD 575.00), 95% CI [-857.98; 1395.98], contributing 0.1%. Mat et al. (2020) observed 115.00 (SD 20.00), 95% CI [75.80; 154.20], weighted at 93.8%. Nurbett et al. (2023) found 80.00 (SD 97.50), 95% CI [-111.10; 271.10], contributing 3.9%. The pooled analysis yielded a mean difference of 74.76 to 150.69 (95% CI), with no observed heterogeneity (Tau² = 0; Chi² = 0.38, df = 4, P = 0.98; I² = 0%).
Conclusion: Meta-analysis of blood loss in vNOTES gynecological surgery for patients with BMI >30 showed significant variation (62.29-127.20), with a pooled mean of 94.76 to 150.69. Consistency across studies was confirmed by the absence of heterogeneity.