经脐单孔腹腔镜与传统三孔腹腔镜卵巢囊肿剔除术的对比研究

Comparative study on transumbilical laparoendoscopic single-site surgery and the three-port laparoscopy in treatment of ovarian cystectomy

目的 比较经脐单孔腹腔镜与传统三孔腹腔镜卵巢囊肿剔除术的临床效果.方法 选择2012年2月至2013年6月在中国医学科学院北京协和医院拟行卵巢囊肿手术的患者54例,随机分为单孔腹腔镜组（24例）和三孔腹腔镜组（30例）;分析比较两组患者的手术时间、术中出血量、并发症、术后疼痛评分、术后镇痛药物使用情况、住院时间、术后美容满意度和总费用等.结果 单孔腹腔镜组和三孔腹腔镜组术中出血量[分别为（25±17）、（24±18） ml]、术后住院时间[分别为（2.9±0.9）、（2.5±0.4）d]、并发症发生情况（均为0例）、术后镇痛药物使用情况[分别为2、3例]及总费用[分别为（5 524±1 078）、（5 200±1 269）元]比较,差异均无统计学意义（P＞0.05）.三孔腹腔镜组和单孔腹腔镜组手术时间分别为（31±10）和（40 ±19） min;术后第1天,疼痛视觉模拟评分（VAS）分别为（5.6±1.7）和（2.7±1.4）分;术后美容满意度评分分别为（92.5±2.5）和（97.4±1.5）分,两组分别比较,差异均有统计学意义（P＜0.05）.结论 单孔腹腔镜治疗良性卵巢囊肿是安全可行的,且能明显减轻患者的术后疼痛,并能达到更好的美容效果.

Objective To investigate clinical outcome of laparoendoscopic single-site compared with traditional three-port in treatment of ovarian cystectomy.Method From February 2012 to June 2013,54 patients with ovarian cyst were randomized to the single-site group （n =24） or the three-port group （n =30） in Peking Union Medical College Hospital.The outcome of laparoscopic single-site and three-port ovarian cystectomy were evaluated.Operation time,blood loss,surgical complications,postoperative pain score,postoperative analgesic requirements,length of hospital stay,cosmetic satisfaction score,postoperative recovery and total cost were compared between both groups.Results No difference was found in blood loss,length of hospital stay,complications and total cost between the two groups（P 〉 0.05）.Operation time was （31-± 10） minute in three-port group and （40 ± 19） minute in single-site group.Visual analogue pain score was 5.6 ± 1.7 in three-port group and 2.7 ± 1.4 in single-site group,cosmetic satisfaction score was 92.5 ± 2.5 in three-port group and 97.4 ± 1.5 in single-site group.Those clinical parameter reached statistical difference （all P 〈 0.05）.Conclusion Laparoendoscopic single site surgery approach is feasible and safe to treat benign ovarian cyst disease.And it offers decreased pain and offer improved cosmesis.