经脐单孔腹腔镜与传统腹腔镜治疗卵巢成熟畸胎瘤的疗效对比研究

Comparison of laparoendoscopic single-site versus conventional laparoscopic ovarian cystectomy for ovarian mature cystic teratoma

目的评估单孔腹腔镜与传统腹腔镜卵巢囊肿切除术治疗卵巢成熟畸胎瘤的疗效及其对卵巢储备功能的影响。方法选取2017年7月至2018年9月本院卵巢成熟畸胎瘤131例,采用分层随机化方法随机分为单孔腹腔镜组(n=68)和对照组(n=63),比较两组患者的术中和术后情况,包括满意度评分及卵巢储备功能。结果与对照组相比,单孔腹腔镜组手术时间缩短[(28.31±4.64)min,(43.14±7.83)min]、术中出血量减少[(45.65±16.61)ml,(61.17±12.91)ml]、术后通气时间缩短[(17.82±3.40)h,(25.33±3.82)h]、术后住院时间减少[(2.91±0.51)d,(3.81±0.69)d]、囊肿腹腔内破裂率降低7.4%和33.3%、疼痛评分降低[(1.04±0.74)分,(2.02±0.83)分]及满意度评分更高[(9.34±0.48)分,(7.13±0.61)分],差异均有统计学意义(P<0.01)。结论单孔腹腔镜手术是治疗卵巢成熟畸胎瘤更为合适的手术方式。

Objective To estimate the efficacy of laparoendoscopic single-site(LESS)versus conventional laparoscopic ovarian cystectomy in ovarian mature cystic teratoma and its effect on ovarian reserve function.Methods 131 patients with ovarian mature cystic teratomas were chosen from July 2017 to September 2018 and randomly divided into LESS group(68 patients)and conventional laparoscopic group(63 patients).The pain score,satisfaction score,and ovarian reserve function were in intraoperative and postoperative compared between the two groups.Results Compared with conventional laparoscopic surgery,the LESS group had shorter operation time[(28.31±4.64)min vs(43.14±7.83)min,P<0.01],Intraoperative blood loss[(45.65±16.61)ml vs(61.17±12.91)ml,P<0.01],shortened postoperative ventilation time[(17.82±3.40)h vs(25.33±3.82)h,P<0.01],postoperative hospital stay[(2.91±0.51)vs(3.81±0.69),P<0.01],intra-abdominal rupture rate(7.4%vs 33.3%,P<0.01),lower pain scores(1.04±0.74 vs 2.02±0.83,P<0.01),satisfaction score were higher(9.34±0.48 vs 7.13±0.61,P<0.01),and the difference was statistically significant(P<0.05).Conclusion The LESS is a more appropriate surgical procedure for ovarian mature cystic teratoma.