摘要
目的:探讨经脐与经阴道两种路径在免气腹单孔腹腔镜妇科手术中的临床效果。方法:选择2018年8月至2019年8月收治的72例异位妊娠、附件囊肿、子宫肌瘤、不孕症患者,其中36例经脐行免气腹单孔腹腔镜手术(对照组),36例经阴道行免气腹单孔腹腔镜手术(研究组),对比分析手术时间、术后下床活动时间、住院时间、出血量、肛门排气时间、中转手术等指标。结果:两组各有2例因术野暴露欠佳改行单孔气腹腹腔镜手术,各有1例因不孕症盆腔致密粘连改行3孔法气腹腹腔镜手术。研究组术后肛门排气时间、术后疼痛、术后下床活动时间、住院时间优于对照组,差异有统计学意义(P<0.05),两组手术时间、出血量、中转气腹手术例数差异无统计学意义(P>0.05)。结论:经阴道免气腹单孔腹腔镜妇科手术疼痛轻,腹部无切口,创伤小,康复快,可作为妇科腹腔镜手术的选择之一。
Objective:To explore the clinical effect of transumbilical and transvaginal gasless single-port laparoscopy in gynecological surgery.Methods:Seventy-two patients with ectopic pregnancy,adnexal cyst,hysteromyoma or infertility from Aug.2018 to Aug.2019 were selected,36 patients underwent transumbilical gasless single-port laparoscopy(control group),and 36 patients underwent the transvaginal gasless single-port laparoscopy with the same disease and by the same surgeon(research group).The observation indexes were the operation time,postoperative ambulation time,hospital stay,bleeding volume,anal exhaust time,conversion to pneumoperitoneum laparoscopic surgery,etc.Results:Two patients in each group were converted to single-port pneumoperitoneum laparoscopic surgery due to poor exposure of the operation field,and 1 infertility patient in each group completed pneumoperitoneum 3-port laparoscopic surgery due to pelvic dense adhesion.The research group was statistically significantly better than control group in terms of postoperative anal exhaust time,postoperative pain,postoperative ambulation time and hospital stay(P<0.05),but there was no statistically significant difference in operation time,blood loss and the number of conversion to pneumoperitoneum laparoscopic surgery between the two groups(P>0.05).Conclusions:Transvaginal gasless single-port laparoscopy has less pain,no abdominal incision,fewer trauma and faster recovery than transumbilical gasless single-port laparoscopy.This procedure can be an alternative of gynecological laparoscopy.
作者
罗迎春
于江
莫洪敏
于锦玉
胡玲顺
钟俊妍
李瑾
LUO Ying-chun;YU Jiang;MO Hong-min(Department of Gynaecology,Guilin People’s Hospital,Guilin 541002,China)
出处
《腹腔镜外科杂志》
2020年第10期779-782,共4页
Journal of Laparoscopic Surgery
基金
桂林市科学研究与计数开发计划项目(20190218-7-4)。
关键词
妇科外科手术
腹腔镜检查
单孔
经脐
经阴道
免气腹
Gynecologic surgical procedures
Laparoscopy
Single-port
Transumbilical
Transvaginal
Gasless
