经阴道单孔腹腔镜手术在卵巢良性肿瘤中的应用

The application of transvaginal single-port laparoscopic surgery in benign ovarian tumor

目的:探讨经阴道单孔腹腔镜手术(V-NOTES)治疗卵巢良性肿瘤的可行性与安全性。方法:回顾分析2017年12月至2019年10月收治的40例卵巢良性肿瘤患者的临床资料,根据手术方式分为V-NOTES组(n=20)与经脐单孔腹腔镜手术(TU-LESS)组(n=20),对比分析两组手术时间、术中出血量、血红蛋白变化值、术后48 h最高体温、术后首次肛门排气时间、术后住院时间、治疗费用、疼痛视觉模拟评分及美容评分。结果:两组手术均顺利完成。两组手术时间、术中出血量、血红蛋白变化值、术后48 h最高体温、术后住院时间及住院费用差异无统计学意义,但V-NOTES组首次肛门排气时间、疼痛评分、美容评分优于TU-LESS组。结论:与TU-LESS相比,V-NOTES治疗卵巢良性肿瘤疼痛轻、术后康复快、美容效果好。

Objective:To investigate the feasibility and safety of transvaginal natural orifice transluminal endoscopic surgery(V-NOTES)for benign ovarian tumors.Methods:The clinical data of 40 patients with ovarian benign tumor were retrospectively analyzed from Dec.2017 to Oct.2019 retrospectively.According to the way of operation,they were divided into V-NOTES group(n=20)and transumbilical laparoendoscopic single site surgery(TU-LESS)group(n=20).The operative time,blood loss,change of hemoglobin,maximum body temperature of 48 h after operation,recovery time of intestinal function,postoperative hospital stay,cost of treatment,pain visual analogue score and cosmetic score were analyzed and compared between the two groups.Results:The operation was successfully completed in both groups.There was no significant difference in the operative time,blood loss,change of hemoglobin,maximum body temperature of 48 h after operation,postoperative hospital stay and cost of treatment between the two groups.However,the recovery time of intestinal function and pain score in V-NOTES group were significantly less than those in TU-LESS group,while the cosmetic score of the V-NOTES group was significantly higher than that of the TU-LESS group.Conclusions:In the surgical treatment of the benign ovarian tumor,the V-NOTES can relieve the pain of patients,the recovery is faster and the appearance is better than TU-LESS operation.