摘要
目的:比较经阴道自然腔道内镜手术(v-NOTES)与经脐单孔腹腔镜(u-LESS)全子宫切除术的临床疗效,探讨v-NOTES在临床应用的优势。方法:回顾分析2018年7月至2022年10月由同一名医师主刀操作的34例v-NOTES(v-NOTES组)与38例u-LESS(u-LESS组)患者的临床资料,对比两组术中及术后临床相关指标,并总结同一名医师行v-NOTES与u-LESS全子宫切除术的学习曲线。结果:两组患者年龄、BMI、产次、腹部手术史及子宫径线差异无统计学意义(P<0.05)。两组手术时间、术后住院时间、术后12 h疼痛评分差异无统计学意义(P>0.05)。v-NOTES组术中出血量多于u-LESS组,肛门排气时间、术后下床活动时间、术后留置尿管时间短于u-NOTES组,术后患者满意度高于u-NOTES组,差异均有统计学意义(P<0.05)。两种术式的学习曲线差异无统计学意义。结论:v-NOTES是适宜推广的术式,在术后恢复方面优于u-LESS。
Objective:To compare the clinical effect between vaginal natural orifice transluminal endoscopic surgery(v-NOTES)and umbilical laparoendoscopic single-site surgery(u-LESS)total hysterectomy,and to investigate the advantages of v-NOTES in clinical application.Methods:Retrospective analysis was made on the clinical data of 34 cases of v-NOTES total hysterectomy(v-NOTES group)and 38 cases of u-LESS total hysterectomy(u-LESS group)operated by the same doctor from Jul.2018 to Oct.2022,the preoperative baseline information,intraoperative and postoperative clinical data of the two groups were compared.The learning curve of the same doctor using the v-NOTES and u-LESS methods for total hysterectomy was summarized.Results:There was no statistically significant difference in baseline information between the v-NOTES group and the u-LESS group in terms of age,BMI,parity,history of abdominal surgery,and average uterine diameter(P<0.05).There was no statistically significant difference between the v-NOTES group and the u-LESS group in the surgical time,postoperative hospital stay,postoperative indwelling urinary catheter time,and postoperative 12 h pain score(P>0.05).Compared with the u-LESS group,the v-NOTES group had more intraoperative blood loss,shorter anal e xhaust time,earlier postoperative ambulation,and higher scores in postoperative patient satisfaction,all differences were statistically significant(P<0.05).There was no significantly statistical difference in the learning curve between the two techniques.Conclusions:In the selection of surgical methods for single port laparoscopic total hysterectomy in gynecology,v-NOTES is a suitable method for p romotion,which is superior to u-LESS in postoperative recovery.
作者
周静
张乔燕
唐丹
李韵霞
姚华
欧阳静茹
贾小平
ZHOU Jing;ZHANG Qiaoyan;TANG Dan(Department of Gynecology,Xinjiang Karamay City Central Hospital,Karamay 834000,China;Clinical Medical Research Center,Xinjiang Digestive System Tumor Precision Medicine)
出处
《腹腔镜外科杂志》
2023年第8期614-618,共5页
Journal of Laparoscopic Surgery
基金
新疆维吾尔自治区自然科学基金(2019D01A09)
青年基金项目(2021D01B11)。
关键词
子宫切除术
腹腔镜检查
单孔
经阴道
经脐
Hysterectomy
Laparoscopy
Single port
Transvaginal
Transumbilical
