单孔腹腔镜在妇科良性疾病中的临床应用

Clinical application of laparoendoscopic single-site surgery in gynecological benign diseases

目的探讨单孔腹腔镜手术(LESS)治疗妇科良性疾病的安全性、可行性及价值。方法103例妇科良性疾病患者,根据手术方法不同分为观察组(52例)和对照组(51例)。观察组行经脐单孔腹腔镜手术,对照组行多孔腹腔镜手术。比较两组围手术期指标;术后并发症发生情况;术后疼痛、出院时间、美观满意度。结果观察组手术时间长于对照组,术后肠道功能恢复时间短于对照组,差异均有统计学意义(P<0.05)。两组术中出血量比较差异无统计学意义(P>0.05)。观察组并发症发生率15.4%与对照组的17.6%比较,差异无统计学意义(P>0.05)。观察组术后疼痛发生率40.4%低于对照组的66.7%,出院时间(3.3±1.1)d短于对照组的(5.8±1.2)d,美观满意度96.2%高于对照组的62.7%,差异均有统计学意义(P<0.05)。结论单孔腹腔镜手术治疗妇科良性疾病安全、可行。与常规腹腔镜手术相比,创伤低、恢复快、安全性高、美容效果佳。

Objective To discuss the safety,feasibility and value of laparoendoscopic single-site surgery(LESS)in gynecological benign diseases.Methods A total of 103 patients with gynecological benign diseases were divided into observation group(52 cases)and control group(51 cases).The observation group was treated by transumbilical laparoendoscopic single-site surgery,and the control group was treated by laparoendoscopic multiple-site surgery.The perioperative indicators,occurrence of complications after surgery,pain after surgery,hospitalization time and aesthetic satisfaction were compared between the two groups.Results The surgery time of the observation group was longer than that of the control group,and intestinal function recovery time after surgery was shorter than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in amount of intraoperative hemorrhage between the two groups(P>0.05).The incidence of complications 15.4%of the observation group had no statistically significant difference compared with that of the control group 17.6%(P>0.05).The incidence of pain after surgery 40.4%was lower than that of the control group 66.7%,and hospitalization time(3.3±1.1)d was shorter than that of the control group(5.8±1.2)d,and aesthetic satisfaction degree 96.2%was higher than that of the control group 62.7%,and the difference was statistically significant(P<0.05).Conclusion Laparoendoscopic single-site surgery is safe and feasible in the treatment of gynecological benign diseases.Compared with conventional laparoscopic surgery,it has smaller trauma,quicker recovery,higher safety and better cosmetic effect.