单孔腹腔镜在深部浸润型子宫内膜异位症中的应用及初步探讨

Primary study on laparoendoscopic single-site surgery in deeply infiltrating endometriosis

目的初步探讨单孔腹腔镜手术在深部浸润型子宫内膜异位症(deeply infiltrating endometriosis,DIE)中的可行性、安全性及围手术期结局。方法回顾性分析空军军医大学西京医院妇产科于2017年5月至2018年8月共完成的6例单孔腹腔镜DIE病灶切除术。记录患者年龄、体质量指数、手术时间、术中出血量、病灶直径、术中及术后相关并发症,手术前后血红蛋白差值,术后排气时间、术后疼痛模拟评分、住院时间、术后随访情况等指标。结果 6例患者的手术均成功完成,无中转传统腹腔镜手术或开腹手术,无并发症发生。年龄(32. 3±6. 3)岁,体质量指数(23. 8±5. 6) kg/m2,手术时间(106. 5±47. 3) min,术中出血量(27. 6±35. 4) ml,术后排气时间(12. 4±6. 7) h,住院时间(3. 5±2. 7) d。结论单孔腹腔镜对于孤立的界限相对清楚的DIE病灶的手术是安全、可行的,但需进一步扩大病例数证实其可靠性。

Objective To analyze the feasibility,safety and perioperative outcome of laparoscopic single-site surgery in deeply infiltrating endometriosis. Methods Between May 2017 and Aug. 2018,6 patients were diagnosed as deeply infiltrating endometriosis who underwent laparoscopic single-site surgery in Xi Jing Hospital. The perioperative data was analyzed as follows: age,BMI,operative time,blood loss,postoperative VAS pain score,time for bowel movement,size of lesion and hospital stay. Results All6 cases were successfully completed. No one was converted to conventional laparoscopy or laparotomy. No complications occurred during intraoperative and postoperative time. The clinical data were as follows: age( 32. 3 ± 6. 3) years old,body mass index( 23. 8 ± 5. 6) kg/m^2,operation time( 106. 5 ± 47. 3) minutes,intraoperative blood loss( 27. 6 ± 35. 4) ml,postoperative exhaust time( 12. 4 ± 6. 7) h and hospital stay( 3. 5 ± 2. 7) d. Conclusions Laparoscopic single-site surgery is a feasible,safe and effective management in the treatment of deeply infiltrating and isolated endometriosis. Further evaluation of laparoscopic singlesite surgery with increased number of patients is required.