经阴道自然腔道内镜卵巢囊肿剥除术的临床研究

Clinical Study of Ovarian Cystectomy Via Transvaginal Natural Orifice Transluminal Endoscopic Surgery

目的:探索经阴道自然腔道镜手术(vaginal natural orifice transluminal endoscopic surgery,vNOTES)在卵巢囊肿剥除术的临床应用价值。方法:选择2018年6月~2020年6月在江西省妇幼保健院住院的32例卵巢囊肿患者行vNOTES卵巢囊肿剥除术,统计分析手术时间、术中出血量、术后肛门排气时间、术后视觉模拟评分(visual analogue scale,VAS)等临床资料。结果:30例经完成vNOTES手术,2例因子宫直肠窝粘连转经多孔腹腔镜完成手术。患者手术时间(76.07±24.18)min;术中出血量(56.32±49.25)mL;术后24h VAS(2.04±0.56)分;术后排气时间平均(24.17±5.21)h。术后3个月随访,所有vNOTES患者的阴道残端切口愈合良好,无阴道出血及异常分泌物。结论:vNOTES卵巢囊肿剥除术具有美观、术后恢复快等优点,选择合适的患者,vNOTES卵巢囊肿剥除术对卵巢囊肿是一种安全可行的可选术式。

Objective:To explore and establish the clinical value of the technique and application of transvaginal natural orifice transluminal endoscopic surgery(vNOTES)in ovarian cystectomy.Methods:32 patients with ovarian cyst who underwent ovarian cystectomy via vNOTES from June 2018 to June 2020 in the Maternal and Child Health Care Hospital of Jiangxi Province were selected.Then clinical data including operation time,blood loss,recovery time of intestinal function and postoperative pain score were collected and analyzed.Results:Two cases were transferred to traditional laparoscopy due to severe adhesion.The other 30 cases were successfully completed.The average operation time was(76.07±24.18)min;the intraoperative blood loss was(56.32±49.25)mL;the 24h postoperative VAS score was(2.04±0.56)points;the postoperative exhaust time was(24.17±5.21)h.After follow-up for 3 months,all the patients’vaginal stump healed well.All the patients had no vaginal bleeding and abnormal secretion.Conclusions:Ovarian cystectomy via vNOTES has an advantage in cosmetic results and rapid postoperative recovery.With appropriate case selection,ovarian cystectomy via vNOTES is a safe and feasible option.