经脐单孔腹腔镜卵巢囊肿手术

Transumbilical Laparoendoscopic Single-site Surgery for Ovarian Benign Tumor

目的探讨经脐单孔腹腔镜卵巢囊肿手术的安全性。方法回顾性分析2017年10月~2018年9月59例附件区单孔腹腔镜手术资料(其中8例妊娠合并卵巢肿瘤行腹壁悬吊式单孔腹腔镜手术),并与同期62例常规三孔腹腔镜手术进行对比。结果2组均未中转开腹,与常规腹腔镜组比较,单孔腹腔镜组手术时间长[(95.3±46.0)minvs.(67.0±27.4)min,t=4.077,P=0.000],但疼痛轻[术后1天疼痛视觉模拟评分(Visual Analogue Scale,VAS)(1.6±0.5)分vs.(2.0±0.4)分,t=-4.569,P=0.000],2组术中出血量、术后排气时间、术后住院时间无明显差异(P>0.05)。2组均未发生腹壁血管、神经损伤,无泌尿系损伤等并发症。结论单孔腹腔镜手术可安全地应用于卵巢良性疾病。

Objective To explore the safety of the operation of the transumbilical single-port laparoscopic surgery for ovarian tumor. Methods A retrospective analysis was made on 62 cases of single-port laparoscopic surgery in adnexal region from October 2017 to September 2018( 8 cases of pregnancy complicated with ovarian tumor underwent abdominal wall suspension single-port laparoscopic surgery). Another 62 cases of routine three-port laparoscopic surgery in the same period were selected for comparison.Results No conversion to laparotomy occurred in both groups. The operation time of single-port laparoscopy group was longer than that of conventional laparoscopy group [( 95. 3 ± 46. 0) min vs.( 67. 0 ± 27. 4) min,t = 4. 077,P = 0. 000],but the Visual Analogue Scale( VAS) of pain in the first day after surgery of single-port laparoscopy group was lower than that of conventional laparoscopy group[( 1. 6 ± 0. 5) points vs.( 2. 0 ± 0. 4) points,t =-4. 569,P = 0. 000]. There was no significant difference in intraoperative bleeding,postoperative flatus time and postoperative hospital stay between the two groups( P > 0. 05). There were no complications such as abdominal wall blood vessel,nerve injury,or urinary system injury. Conclusion Single-port laparoscopic surgery can be safely used in benign gynecological adnexal diseases.