经脐单孔腹腔镜手术治疗54例妇科良性病变的临床分析

Analysis of 54 patients with gynecological benign lesions treated by transumbilical single-port laparoscopic surgery

目的探讨经脐单孔腹腔镜手术应用在妇科良性病变治疗中的可行性及安全性.方法回顾性研究2018年4-10月采用经脐单孔腹腔镜手术治疗的54例妇科良性病变患者的临床资料及同期采用多孔腹腔镜治疗的46例妇科良性病变患者的临床资料.结果54例经脐单孔腹腔镜手术均顺利完成,无中转多孔腹腔镜或开腹手术,其中单侧输卵管切除平均手术时间(32.31±13.48)min,单侧卵巢囊肿剔除平均手术时间(47.62±15.86)min,子宫肌瘤剔除平均手术时间(65.45±16.80)min,全子宫切除平均手术时间(94.00±15.17)min,单侧附件切除平均手术时间(55.00±27.39)min,各手术时间与多孔腹腔镜组相比无显著差异(P>0.05).经脐单孔腹腔镜手术组与多孔腹腔镜手术组的术中出血量、术后排气时间、术后并发症、住院总费用均无显著差异(P>0.05),但2组术后对切口疼痛及外观的满意度评分差异有统计学意义(P<0.05).结论经脐单孔腹腔镜手术应用在妇科良性疾病的治疗中是可行的,安全性类似多孔腹腔镜手术,但对于有美观要求的女性,经脐单孔腹腔镜是更佳的选择.

Objective To explore the feasibility and safety of transumbilical single-port laparoscopic surgery in the treatment of benign gynecological lesions. Methods The clinical data of 54 cases with benign gynecological benign lesions treated with transumbilical single-hole laparoscopic surgery from April to October 2018,and 46 cases with benign gynecological benign lesions in the same period treated by porous laparoscopic surgery were analyzed. Results Fifty-four patients underwent transumbilical single-port laparoscopic surgeries successfully. There was no patient transferring to porous laparoscopic or open surgeries. The average operation time of unilateral salpingectomy was(32. 31 ± 13. 48) min,the average operation time of removal of ovarian cysts was(47. 62 ±15. 86) min,the average operation time of uterine leiomyoma was(65. 45 ± 16. 80) min,the average operation time of total hysterectomy was(94. 00 ± 15. 17) min,the average operation time of unilateral attachment removal was(55. 00 ± 27. 39) min. The operative time above in the transumbilical single-port laparoscopic surgery group showed no significant differences compared to the porous laparoscopic surgery group(P > 0. 05). There were no significant differences in the amount of bleeding,postoperative exhaust time,postoperative complications,total hospitalization costs(P > 0. 05). Postoperative satisfaction towards wound pain and appearance showed statistically significant differences.Conclusion Transumbilical single-port laparoscopic surgery is feasible and is as safe as porous laparoscopic surgery. Transumbilical single-port laparoscopy is a better choice for young women with aesthetic requirements.