经脐单孔腹腔镜手术治疗妇科良性疾病的临床效果分析

Analysis of clinic effects of transumbilical laparoendoscopic single site surgery for benign gynecological diseases

目的比较经脐单孔腹腔镜与传统腹腔镜治疗妇科良性疾病的临床效果。方法回顾性分析比较2019年8月至2020年8月于川北医学院附属南充市中心医院初始治疗为手术的妇科良性疾病患者的临床效果,其中卵巢良性肿瘤132例,子宫肌瘤90例,子宫腺肌症48例,卵巢子宫内膜异位囊肿45例,根据手术方式分为经脐单孔腹腔镜(观察组105例)和传统腹腔镜(对照组210例)两组,同时根据手术术式的不同将观察组、对照组再细分为子宫切除组(111例)、子宫肌瘤切除术组(27例)、卵巢良性肿瘤切除术组(177例)。结果两组均无中转开腹,术后均无并发症发生。观察组美容满意度评分、卵巢良性肿瘤组手术时间高于对照组(P<0.05);子宫肌瘤切除术和卵巢良性肿瘤的标本取出时间观察组低于对照组,差异有统计学意义(P<0.05);观察组的术后排气时间、术后住院时间、术后疼痛评分均低于对照组(P<0.05);两组比较,术中出血量、子宫肌瘤切除术和子宫切除术组手术时间无统计学差异(P>0.05)。结论经脐单孔腹腔镜手术具有美容满意度高、疼痛程度低、标本取出时间短等优点,有一定临床推广价值。

Objective To compare clinic effects of transumbilical laparoendoscopic single site surgery(TU-LESS)in patients with benign gynecological diseases.Methods 315 cases with benign gynecological diseases(132 cases bengin ovarian tumor,90 cases uterine myoma,48 cases adnomyomsis,45 cases ovarian endometriosis)hospitalized in the Affiliated Nanchong Central Hospital of North Sichuan Medical College from August 2019 to August 2020 were collected,and were divided into observation group(received TU-LESS,n=105)and control group(received converntiaonal laparoscopic surgery,n=210)and further classified into hysterectomy group(n=111),myomectomy group(n=27),benign ovarian tumors resection group(n=177)according to surgical approach.The operation time of benign ovarian tumors,hysterectomy and myomectomy,postoperative cosmetic satisfaction score,specimen retrieval time,postoperative exhaust time,postoperative hospital stay,postoperative pain score,intraoperative blood loss of two groups were compared.Results There was no patient transfered to laparotomy in two groups with no postoperative complications.The operation time of benign ovarian tumors and postoperative cosmetic satisfaction score of obeservation group were higher than that in the control group(P<0.05).The hysterectomy and myomectomy specimen retrieval time of obeservation group were shorter than that in the control group(P<0.05).The postoperative exhaust time,postoperative hospital stay and postoperative pain score of obeservation group were lower than that in the control group(P<0.05).There were no significant diference in intraoperative blood loss between two groups(P>0.05).Conclusions Transumbilical laparoendoscopic single site surgery has certain clinical promotion value in term of postoperative cosmetic satisfaction score,specimen retrieval time and postoperative pain score.