经脐单孔腹腔镜在巨大卵巢肿瘤手术的可行性及优势分析

Feasibility and advantages of transumbilical single-port access(SPA)laparoscopy surgery for giant ovarian tumors

目的分析经脐单孔腹腔镜行巨大卵巢肿瘤手术可行性、安全性及优势,为临床手术方式的确定提供依据。方法回顾性分析2018年8月—2022年5月就诊于宁夏医科大学总医院妇科行腹腔镜手术的卵巢巨大肿瘤患者301例(直径≥10 cm),依据手术入路分为单孔腹腔镜组(145例)和传统腹腔镜组(156例)。采用SPSS 24.0软件对所有患者临床资料数据进行对比统计分析,以P<0.05为差异有统计学意义。结果在行腹腔镜治疗的巨大卵巢肿瘤患者中,相比于传统腹腔镜组,单孔腹腔镜组实际手术时间较短(Z=-5.884)、术后胃肠道功能恢复时间较短(Z=-13.604)、术后住院时间较短(Z=-8.155),术中囊液外渗比例较低(χ^(2)=71.508)、围术期并发症例数较少(Z=-1.997)(P<0.05)。而术中出血量(Z=-1.653)、术后12 h视觉模拟量表(visual analogue scale,VAS)评分(Z=-0.813),两组患者比较差异无统计学意义(P>0.05)。结论单孔腹腔镜治疗卵巢巨大肿瘤患者中具有术中囊液外渗可能性小、手术时间短、胃肠道功能恢复时间短、术后住院时间较短及围术期并发症较少等优势,是一种安全可行的治疗巨大卵巢肿瘤的手术方式。

Objective To analyze the feasibility,safety and advantages of transumbilical single-port access(SPA)laparoscopy surgery for giant ovarian tumors and to provide a basis for determining the surgical approach in clinical practice.Methods We retrospectively analyzed 301 patients with giant ovarian tumors(diameter≥10 cm)who visited Ningxia Medical University General Hospital for laparoscopic surgery from August 2018 to May 2022,and divided them into the single-port laparoscopy group(145 patients)and the multi-port laparoscopy group(156 patients)according to the surgical access.The SPSS 24.0 software was used to compare and statistically analyze the clinical data of all patients,and the difference was considered statistically significant at P<0.05.Results Among all the cases with giant ovarian tumors treated laparoscopically,the single-port laparoscopy group had shorter actual operative time(Z=-5.884),shorter postoperative recovery time of gastrointestinal function(Z=-13.604),shorter postoperative hospital stay(Z=-8.155),and lower proportion of intraoperative cystic fluid extravasation compared with the multi-port laparoscopy group(χ^(2)=71.508)(P<0.05).As for the intraoperative bleeding volume,postoperative 12-hour VAS(visual analogue scale)scores and the number of perioperative complications,there were no statistically significant differences between the two groups(P>0.05).Conclusion Transumbilical single-port access(SPA)laparoscopy surgery is a safe and feasible surgical procedure for the treatment of giant ovarian tumors,because it has the advantages of less possibility of intraoperative extravasation of cystic fluid,shorter operative time,shorter recovery time of gastrointestinal function,shorter postoperative hospital stay,and lower rate of perioperative period complications in the patients with giant ovarian tumors.