摘要
目的探讨单一部位切口腹腔镜手术(laparoendoscopic single-site surgery,LESS)在巨大卵巢肿瘤(直径>10 cm)中的应用价值。方法对2017年4月~2018年12月在我院因巨大卵巢囊肿行卵巢囊肿剔除或患侧附件切除的46例资料进行回顾性分析,其中LESS 23例,肿瘤直径(16.32±5.06)cm,传统三孔腹腔镜手术23例,肿瘤直径(14.08±2.78)cm,2组差异无显著性(t=1.861,P=0.069)。比较2组手术时间、术中出血量、手术并发症、术后24 h疼痛视觉模拟评分(Visual Analogue Scale,VAS)、住院时间、术后满意度。结果LESS组行卵巢囊肿剔除18例,患侧附件切除2例,卵巢肿瘤分期手术(大网膜部分切除+盆腔及腹主动脉旁淋巴结活检)3例;三孔组分别为16例、6例、1例。2组手术过程顺利,均无术中及术后并发症。LESS组无囊肿破裂,三孔组囊肿破裂5例(21.7%),差异有显著性(P=0.049),2组术式、手术时间、术中出血量、术后住院时间差异无显著性(P>0.05),但术后切口疼痛VAS评分LESS组[(4.17±1.24)分]高于三孔组[(3.47±0.94分)](t=2.157,P=0.036)。术后6个月2组满意度差异无显著性(P>0.05)。结论对于巨大卵巢肿瘤,LESS手术难度低,探查全面,安全可行,患者满意度高,具有一定的应用价值。
Objective To investigate the value of laparoendoscopic single-site surgery(LESS)in the treatment of giant ovarian tumors(>10 cm).Methods A total of 46 patients with giant ovarian cyst who underwent cystectomy or salpingo-oophorectomy from April 2017 to December 2018 in our hospital were studied retrospectively.Among them,there were 23 cases of LESS(LESS group),with the tumor diameter of(16.32±5.06)cm,and 23 cases of traditional three-port laparoscopic surgery(three-port group),with the tumor diameter of(14.08±2.78)cm.There was no significant difference between the two groups(t=1.861,P=0.069).The operation time,intraoperative blood loss,surgical complication,24-hour postoperative pain Visual Analogue Scale(VAS)score,length of hospital stay,and postoperative satisfaction were compared between the two groups.Results In the LESS group,18 patients had ovarian cyst removal,2 patients had adnexectomy,and 3 patients had ovarian tumor staging surgery.In the three-port group,16 patients had ovarian cyst removal,6 patients had adnexectomy,and 1 patient had ovarian tumor staging surgery.All the surgeries were completed successfully without any complications.There was no rapture of cyst in the LESS group and 5 cases(21.7%)in the three-port group,with significant difference(P=0.049).There was no significant difference in surgery type,operative time,intraoperative bleeding and postoperative hospital stay between the two groups(P>0.05).But the postoperative VAS pain score of the LESS group[(4.17±1.24)points]was higher than that of the three-port group[(3.47±0.94)points,t=2.157,P=0.036].There was no significant difference in the 6-month postoperative satisfaction between the two groups(P>0.05).Conclusions To treat large ovarian tumors,LESS is safe and feasible,and easy to perform.It provides comprehensive exploration and offers high satisfaction,which has certain application value.
作者
张坤
王一婷
姚颖
杨俊芳
韩劲松
Zhang Kun;Wang Yiting;Yao Ying(Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China)
出处
《中国微创外科杂志》
CSCD
北大核心
2020年第5期421-423,共3页
Chinese Journal of Minimally Invasive Surgery
基金
国家重点研发计划“生殖健康及重大出生缺陷防控研究”重点专项(2016YFC1000900,2016YFC1000904)。
