经脐单孔腹腔镜手术治疗卵巢畸胎瘤的临床疗效及对术后激素水平的影响

Clinical efficacy of umbilical single-port transumbilical laparoscopic surgery for ovarian teratoma and its effect on postoperative hormone levels

目的探讨经脐单孔腹腔镜手术治疗卵巢畸胎瘤的临床疗效及对术后激素水平的影响.方法采用随机数字表法将98例拟行腹腔镜卵巢畸胎瘤剔除手术的患者随机分为观察组和对照组,每组49例.观察组患者接受经脐单孔腹腔镜手术治疗,对照组患者接受传统三孔腹腔镜手术治疗,比较两组患者围手术期指标(手术时间、术中出血量、肠道功能恢复时间、拔除导尿管时间和住院时间)、血清激素水平[黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇、抗苗勒管激素(AMH)]和对腹部外观的满意度.结果观察组患者的手术时间明显长于对照组患者,肠道功能恢复时间和住院时间均明显短于对照组患者,术中出血量明显少于对照组患者,差异有统计学意义(P﹤0.01).手术前、术后3个月、术后6个月,两组患者血清LH、FSH、雌二醇、AMH水平比较,差异均无统计学意义(P﹥0.05).术后3个月,观察组患者对手术后外观的满意度优于对照组患者,差异有统计学意义(P﹤0.05).结论经脐单孔腹腔镜手术治疗卵巢畸胎瘤术后恢复快、外观满意度高.

Objective To explore the clinical effect of single-port transumbilical laparoscopic surgery for ovarian teratoma and its effect on hormone levels after surgery. Method A total of 98 patients who underwent laparoscopic surgery for ovarian teratoma removal were included in the study and randomized as study group and control group, containing 49 cases in each, receiving single- port transumbilical laparoscopic surgery and traditional three- port surgery, respectively. The operative time, intraoperative blood loss, time to recovery of intestinal function, time to catheter removal, and length of hospital stay were recorded and compared between the two groups, besides, the serum level of hormones[luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and anti-mullerian hormone (AMH)], as well as the degree of satisfaction regarding the abdominal appearance of patients were also evaluated. Result The operative time of study group was significantly longer than that of the control group, and the time to recovery of intestinal function and hospital stay were less compared to control group, the study group was observed with evidently less intraoperative blood loss than control group with statistically significant difference noted (P<0.01). Before surgery, and in 3 months and 6 months after surgery, the serum levels of LH, FSH, estradiol and AMH were similar between the two groups (P>0.05). In 3 months after operation, patients in the single-port surgery group rated higher for their degree of satisfaction regarding the postoperative abdominal appearance compared to those who received traditional surgery, and the difference was statistically significant (P<0.05). Conclusion The single-port transumbilical laparoscopic surgery for ovarian teratoma may accelerate the recovery after surgery, with higher degree of satisfaction regarding the postoperative abdominal appearance among patients.