摘要
目的探讨单孔腹腔镜下子宫肌瘤剥除术的安全性与可行性。方法回顾性分析2018年7月2019年11月南京医科大学附属常州第二人民医院妇科行腹腔镜手术治疗的40例子宫肌瘤患者的临床资料。根据手术方式分为单孔腹腔镜组(LESS组)和传统多孔腹腔镜组(MPLS组),各20例。观察并比较两组患者的手术时间、术中出血量、血红蛋白下降值、术后首次肛门排气时间、术后住院天数、治疗费用、美容评分(CS)以及疼痛视觉模拟评分(VAS)。结果两组患者均顺利完成手术,无中转开腹,无皮下气肿及穿刺孔周围损伤出血等并发症。两组患者的手术时间、血红蛋白下降值以及首次肛门排气时间无统计学差异(P>0.05)。LESS组术中出血量、治疗费用及CS评分明显高于MPLS组,术后住院天数、术后12 h VAS评分显著低于MPLS组,差异均有统计学意义(P<0.05)。结论单孔腹腔镜下行子宫肌瘤剥除术是安全、可行的,可明显减轻患者疼痛,促进患者恢复,达到更好的美容效果。
Objective To investigate the safety and feasibility of hysteromyomectomy under laparoendoscopic single-site surgery.Methods The clinical data of 40 cases with uterine fibroids underwent laparoscopy in the of gynecology department of Changzhou Second People's Hospital Affiliated to Nanjing Medical University from July 2018 to November 2019 was analyzed retrospectively.According to the surgical methods,all cases were divided into two groups with 20 cases for each group.The laparoendoscopic single-site surgery(LESS)and multi-port laparoscopic surgery(MPLS)was performed in the LESS group and MPLS group respectively.The operation time,the loss of blood,the change of hemoglobin,the recovery time of gastrointestinal function,the hospital stays after the operation,the cost of treatment,the cosmetic score(CS)and visual simulation score(VAS)were compared between the two groups.Results The operation was successfully completed in all cases without conversion to open surgery and complications as subcutaneous emphysema,peri-puncture hole bleeding and etc.There was no significant difference in operation time,hemoglobin change and the recovery time of gastrointestinal function between the two groups(P>0.05).Compare to the MPLS group,the blood loss,the cost of treatment and the CS score were higher,and the hospital stays and 12 h VAS score after the surgery were less in the LESS group,and there were significant differences between the two groups(P<0.05).Conclusion Laparoendoscopic single-site surgery is safe and feasible for hysteromyomectomy with relieving the pain,improving the recovery and achieving better cosmetic result.
作者
王慧慧
鲍明月
陈继明
秦真岳
肖惠超
郑亚峰
施如霞
WANG Hui-hui;BAO Ming-yue;CHEN Ji-ming;QIN Zhen-yue;XIAO Hui-chao;ZHENG Ya-feng;SHI Ru-xia(Dalian Medical University, Dalian 116000, Liaoning, China;Department of Gynecology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou 213000, Jiangsu, China)
出处
《中国现代手术学杂志》
2020年第4期295-300,共6页
Chinese Journal of Modern Operative Surgery
基金
江苏省“333工程”科研资助项目(BRA2019161)
江苏省博士后科研资助计划(2019K064)
常州市卫生计生委重大科技项目(ZD201812)
南京医科大学康达学院2018年度教育研究课题(KD2018JYYJYB055)。
关键词
单孔腹腔镜手术
多孔腹腔镜手术
子宫肌瘤
laparoendoscopic single site surgery(LESS)
multi-port laparoscopic surgery(MPLS)
hysteromyoma
