摘要
目的对比经阴道自然腔道内镜手术(transvaginal natural orifice transluminal endoscopic surgery,vNOTES)和经脐单孔腹腔镜(laparoendoscopic single-site surgery,LESS)下卵巢囊肿剥除手术治疗的可行性、安全性及优势。方法回顾性分析2018年8月至2019年9月于成都市妇女儿童中心医院行单侧卵巢囊肿手术治疗患者126例的临床资料,按照手术途径不同分为vNOTES组(50例)与经脐LESS组(76例)。比较两组一般资料、手术相关数据及术后情况等。结果126例患者均顺利完成手术,术中无并发症发生,均未更改手术方式,无1例中转开腹手术。两组年龄、体质量指数(body mass index,BMI)、卵巢囊肿直径、既往手术史等一般资料比较,差异均无统计学意义(P>0.05)。两组手术时间[(75.94±26.54)min vs(72.00±19.48)min]及术后血红蛋白变化量[(21.57±8.25)g/L vs(18.33±10.89)g/L]比较,差异无统计学意义(P>0.05)。vNOTES组排气时间[1(1,1)d]早于经脐LESS组[1(1,2)d],术后24 h视觉模拟评分法(visual analogue scale,VAS)[1(1,1)]低于经脐LESS组[2(2,3)],差异有统计学意义(P<0.01)。两组患者住院时间比较,差异无统计学意义(P>0.05)。结论经vNOTES治疗卵巢囊肿是安全有效的,就术后恢复及患者疼痛程度而言,vNOTES具有更加显著的优势,且因腹壁无伤口更具美容效果。
Objective To evaluate and compare the feasibility,safety and advantage of transvaginal natural orifice transluminal endoscopic surgery(vNOTES)and transumbilical laparoendoscopic single-site surgery(LESS)for ovarian cysts.Methods Retrospe-ctively analyzed the clinical data of 126 patients with ovarian cysts who underwent cystectomy through vNOTES and LESS at Chengdu Women’s and Children’s Central Hospital,between August 2018 and September 2019.There were 50 patients in vNOTES group and the other 76 were at transumbilical LESS group.Results All the operations were successfully performed,without conventions and noticeable complications occurred.For the data of general information(the age,BMI,diameter of ovarian cysts and previous surgical history),there were no significant differences(P>0.05).Compared the two groups surgery data in terms of the mean operation time and the decrease in hemoglobin,all of them did not show significant differences.The exhaust time of vNOTES group[1(1,1)d]was earlier than that of transumbilical LESS group[1(1,2)d].The visual analogus scale(VAS)[1(1,1)]was lower than that of transumbilical LESS group[2(2,3)],the differences were statistically significant(P<0.01).There was no significant difference in hospital stay between the two groups(P<0.05).Conclusion vNOTES and transumbilical LESS were both safe and feasible in ovarian cystectomy surgery.But in terms of patients with postoperative recovery and pain intensity,vNOTES showed significant advantage,which has more cosmetic effect with no abdominal wound.
作者
侯倩男
张凌
何丽
张强
HOU Qiannan;ZHANG Ling;HE Li;ZHANG Qiang(Department of Obstetrics and Gynecology,Chengdu Women's and Children's Central Hospital,Chengdu Sichuan 610091,P.R.China)
出处
《中国计划生育和妇产科》
2020年第10期72-75,共4页
Chinese Journal of Family Planning & Gynecotokology
关键词
经阴道
单孔腹腔镜
卵巢囊肿
transvaginal
laparoendoscopic single-site surgery
ovarian cysts
