单孔腹腔镜在子宫内膜异位症中的应用及研究进展

Laparoendoscopic single-site surgery in endometriosis: current practice and future perspective

腹腔镜手术因其微创的优势,现已成为多种妇科良性、恶性疾病的主要手术方式,但是血管与内脏损伤、切口疝、感染、疼痛等问题在腹腔镜手术中依然存在,单孔腹腔镜通过减少穿刺通道的数量,可以在一定程度上减少这些并发症的发生,并具有更为明显的美容优势。目前单孔腹腔镜领域研究的前沿问题之一是其在子宫内膜异位症特别是卵巢子宫内膜异位囊肿中的应用。若干研究已经证实了单孔腹腔镜在子宫内膜异位症手术治疗中的安全性及可行性,但其是否会进一步损伤卵巢储备,目前仍存在争议。文献表明,在卵巢囊肿剔除术中尽量减少能量器械的使用或能在一定程度上保护卵巢储备。本文将对这些研究做一简单综述。

Laparoscopic surgery has been widely adopted in varieties of benign and malignant gynecologic conditions as it is associated with decreased perioperative complications, enhanced postoperative recovery, shortened hospitalization days and improved incision cosmetic effect. Yet risks of morbidity associated with multiple incisions, including vascular and visceral injury, hernia and infection, pain and other issues still exist. Laparoendoscopic single- site surgery （LESS） may minimize the risks described above and enchance the cosmetic benefits of conventional laparoscopy by performing all the procedures through a small channel in the umbilicus. The safety and feasibility of introducing LESS into endometriosis, especially for treating of ovarian endometrioma, has been confirmed by several studies, while its impact on ovarian reserve still remains controversial, this paper will make a brief summary of these studies.