单孔腹腔镜下囊肿剥除治疗巨大卵巢囊肿的临床效果及对卵巢储备功能、肠道功能的影响

Clinical Effectiveness of Ophorocystectomy of Single-port Laparoscopic Surgery and Its Effects on Ovarian Reserve Function and Intestinal Function of Patients with Giant Ovarian Cysts

目的分析单孔腹腔镜下囊肿剥除治疗巨大卵巢囊肿临床效果及对卵巢储备功能、肠道功能的影响。方法回顾性分析2018年2月—2020年6月收治的102例巨大卵巢囊肿患者临床资料,根据治疗方式分为传统多孔腹腔镜手术(MPLS)组45例和单孔腹腔镜手术(SPLS)组57例。比较2组手术指标和术后肠道功能恢复情况、手术前后卵巢储备功能及免疫功能。结果与MPLS组比较,SPLS组手术时间短,术后肠鸣音恢复时间、排气时间、首次排便时间较短(P<0.05,P<0.01)。与术前比较,2组术后1个月促卵泡激素(FSH)、促黄体生成素(LH)升高,雌二醇(E2)、抗苗勒氏管激素(AMH)、窦卵泡数(AFC)下降,且SPLS组较MPLS组变化更显著(P<0.05,P<0.01)。2组术后CD3+、CD4+及CD8+水平均较术前降低(P<0.05)。结论SPLS对巨大卵巢囊肿患者卵巢储备功能及免疫功能影响小,在手术时间、术后肠道功能恢复方面具备优势,临床可优先选择该术式作为巨大卵巢囊肿的手术方案。

Objective To analyze clinical effectiveness of ophorocystectomy of single-port laparoscopic surgery(SPLS)and its effects on ovarian reserve function and intestinal function of patients with giant ovarian cysts.Methods Clinical data of 102 patients with giant ovarian cysts admitted between February 2008 and June 2020 was retrospectively analyzed,and the patients were divided into traditional multi-port laparoscopic surgery(MPLS)group(n=45)and SPLS group(n=57)according to therapeutic methods.Surgical indicators and recovery condition of intestinal function,and conditions of ovarian reserve function and immune function before and after the surgery were compared between two groups.Results Surgical duration,recovery time of bowel sounds,exhaust time and the first defecation time after surgery in SPLS group were significantly shorter than those in MPLS group(P<0.05,P<0.01).Levels of follicle-stimulating hormone(FSH)and luteinizing hormone(LH)were significantly increased,while levels of estradiol(E2),anti-Müllerian hormone(AMH)and antral follicle number(AFC)were significantly decreased after surgery for 1 month compared with those before surgery in MPLS and SPLS groups,and the changes of the above indicators in SPLS group were more significant than those in MPLS group(P<0.05,P<0.01).After surgery for 6 months,there were no significant differences in levels of FSH,LH,E2,AMH and AFC than those before surgery and between two groups(P>0.05).Levels of CD3+,CD4+and CD8+after surgery were significantly lower than those before operation in MPLS and SPLS groups(P<0.05).Conclusion SPLS has less effects on ovarian reserve function and immune function of patients with giant ovarian cysts,and it has advantages in surgical duration and postoperative recovery of intestinal function.Therefore,this surgical approach can be preferred as a surgical plan for giant ovarian cysts in clinical practice.