无入路平台经脐单切口腹腔镜与多孔腹腔镜卵巢囊肿剥除术的临床效果比较

Comparison of clinical effect between transumbilical single-incision laparoscopic of ovarian cystectomy without single port and conventional multi-port laparoscopic laparoscopic of ovarian cystectomy

目的探讨无入路平台经脐单切口腹腔镜卵巢囊肿剥除术的应用价值。方法将100例需行卵巢囊肿剥除的患者,按照随机数字表法分分为两组,试验组(50例)实施无入路平台经脐单切口腹腔镜卵巢囊肿剥除术,对照组(50例)实施多孔腹腔镜卵巢囊肿剥除术。比较两组的手术时间、术中出血量、住院时间、术后病率、术后肛门排气时间、术后疼痛评分(VAS)、患者满意度等。结果两组患者的术中出血量、手术时间及术后病率差异无统计学意义(P> 0. 05)。试验组住院时间短于对照组,术后疼痛评分(VAS)低于对照组,术后肛门排气时间短于对照组,患者对腹部伤口美容满意度则高于对照组,差异均有统计学意义(P <0. 05)。所有患者手术顺利完成,均无术中、术后严重并发症,无手术死亡病例,无中转开腹手术。结论无入路平台经脐单切口腹腔镜卵巢囊肿剥除术是一种安全、可行、经济,适于在基层医院推广的手术方式,可以达到与单孔腹腔镜一样满意的美容效果和无瘢痕的手术目的,且更容易为患者所接受。

Objective To evaluate the application value of transumbilical single-incision laparoscopic ovarian cystectomy without single port.Methods One hundred patients undergoing the removal of ovarian cysts were randomly divided experimental and control groups.The experimental group(n=50)was treated with transumbilical single-incision laparoscopic ovarian cystectomy without single port,and the control group(n=50)was treated by conventional laparoscopic ovarian cystectomy.The operative time,intraoperative blood loss,hospitalization time,postoperative morbidity,postoperative anal exhaust time,VAS score and patients’satisfaction were compared between the two groups.Results There was no significant difference in blood loss,time of operation and postoperative morbidity between the two groups(P>0.05).The time of hospitalization,postoperative pain score,postoperative anal exhaust time and the patients'satisfaction were significantly improved in the experimental group when compared to the control group(P<0.05).The operation was successful in all cases without postoperative complications,dead cases or failed cases.Conclusions Transumbilical single-incision laparoscopic surgery without single port is a safe,feasible and economical way for ovarian cystectomy.It can achieve the same satisfaction as laparoendoscopic single-site surgery for the purpose of cosmetic and scar-free surgery,and it is more easily accepted by the patients.