经阴道单孔腹腔镜与传统腹腔镜在全子宫切除术中的对比分析

Comparative analysis of transvaginal natural orifice translumenal endoscopic surgery and traditional laparoscopy in hysterectomy

目的 通过对比经阴道单孔腹腔镜手术与传统腹腔镜手术在全子宫切除术中的应用,探讨经阴道单孔腹腔镜手术在全子宫切除术中的应用价值。方法 本研究回顾性选取2018年12月-2021年4月,在克拉玛依市中心医院妇科诊治的经阴道单孔腹腔镜行全子宫切除术25例,根据临床特征匹配同期行传统腹腔镜全子宫切除手术25例患者。对比两组的临床相关指标。结果 两组手术中转率(0%VS 0%),手术时间(119.28±44.60min VS 116.96±50.17min),术后胃肠道功能恢复时间、术后疼痛评分、术后住院时间、手术花费,差异均无统计学意义(P>0.05)。经阴道组与传统组术中出血量(73.80±76.29ml VS 34.4±56.79ml)、血红蛋白水平下降(-10.25±12.14g/L VS-3.83±8.03g/L)、术后24h疼痛评分(VAS)(3.92±1.22分VS 3.28±0.84分)差异均有统计学意义(P<0.05)。结论 经阴道单孔腹腔镜手术在全子宫切除术中是安全可行的,术后美容效果好,且相较于传统腹腔镜手术患者满意度更高。

Objective To explore the application value of V-NOTES in total hysterectomy,by comparing the application of transvaginal natural orifice translumenal endoscopic surgery(V-NOTES) and traditional laparoscopic surgery in hysterectomy.Methods From December 2018 to April 2021,25 cases who underwent hysterectomy by V-NOTES in the department of gynecology at Karamay Central Hospital were retrospectively selected,and 25 cases who underwent traditional laparoscopic hysterectomy were matched at the same time according to clinical characteristics.The clinical indicators of the two groups were compared.Results There were no significant difference in operation transition rate(0% VS 0%),operation time(119.28±44.60 min VS 116.96±50.17 min),postoperative intestinal function recovery time,postoperative pain score,postoperative hospital stay and operation cost between the two groups(P>0.05).Between V-NOTES group and traditional laparoscopy group,the intraoperative blood loss(73.80±76.29 ml VS 34.4±56.79 ml),the decrease of hemoglobin level(-10.25±12.14 g/L VS-3.83±8.03 g/L),24-hour postoperative pain score(3.92±1.22 VS 3.28±0.84) were significant different(P<0.05).Conclusion V-NOTES is safe and feasible in hysterectomy,and the postoperative cosmetic effect is better,and the satisfaction of patients is higher than that of traditional laparoscopic surgery.