自制极简PORT在单孔腹腔镜子宫肌瘤切除术中的应用初步探讨

Primary study on the feasibility and safety of self-made simple PORT in the application of single-port laparoscopic hysteromyomectomy

目的:初步探讨自制极简入路通道(PORT)在单孔腹腔镜子宫肌瘤切除术中应用的可行性及安全性。方法:回顾性分析空军军医大学西京医院妇产科于2017年3月至2018年12月共完成的46例单孔腹腔镜子宫肌瘤切除术患者,其中24例使用商品化PORT,22例使用我科自制极简PORT,所有患者均配合使用常规腹腔镜器械顺利完成手术。比较两组患者年龄、体质量数、手术时间、术中出血量、子宫肌瘤直径、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:所有患者均顺利完成手术,无中转开腹或增加穿刺孔,无并发症发生。商品化PORT组和自制极简PORT组患者的一般资料具有可比性。手术相关指标包括手术时间[(75±56.9)min vs(74±55.7)min]、术中出血量[(55±67.9)ml vs(56±65.8)ml]、子宫肌瘤直径[(6±2.8)cm vs(6±3.4)cm],两组比较无明显统计学差异(P>0.05)。术后恢复指标包括术后排气时间[(12.6±4.4)h vs(13.5±3.4)h]、术后疼痛模拟评分[(2.1±1.3)分vs(2.0±1.2)分]、住院时间[(3.4±2.8)d vs(3.5±2.6)d],同样无统计学差异(P>0.05)。两组手术效果相同,但术中使用自制极简PORT几乎不增加耗材。结论:自制极简PORT在单孔腹腔镜子宫肌瘤切除术中的应用安全性好,效果确切,节约成本,值得推广。

Objective:To investigate the feasibility and safety of self-made simple PORT in the application of single-port laparoscopic hysteromyomectomy.Methods:Between March 2017 and December 2018,46 patients were diagnosed as uterus fibroid who underwent laparoscopic single-port surgery in Xijing Hospital,among which 24 cases were performed with commercialized PORT and 22 cases were performed with self-made simple PORT.All of them were successfully completed with conventional laparoscopic instruments.Patients'age,body mass number,operation time,intraoperative blood loss,uterine fibroid diameter,intraoperative and postoperative complications,postoperative hemoglobin difference,postoperative exhaust time,postoperative pain VAS score,length of hospital stay,postoperative follow-up and other indicators were recorded.Results:All the 46 patients had successfully completed the surgery,without any transfer to laparotomy or increase of puncture hole,and no complications occurred.The data results of commercialized PORT group and self-made simple PORT group showed operation time[(75±56.9)min vs(74±55.7)min],intraoperative blood loss[(55±67.9)ml vs(56±65.8)ml],uterine fibroid diameter[(6±2.8)cm vs(6±3.4)cm],postoperative exhaust time[(12.6±4.4)h vs(13.5±3.4)h],postoperative pain VAS score[(2.1±1.3)scores vs(2.0±1.2)scores],length of hospital stay[(3.4±2.8)d vs(3.5±2.6)d],had no difference.Intraoperative use of self-made simple PORT almost did not increase supplies.Conclusion:The application of self-made simple PORT in the single-port laparoscopic hysteromyomectomy is safe,effective,cost-saving and is worth promoting.