经脐单孔腹腔镜与传统腹腔镜手术治疗卵巢囊肿的疗效对比分析

Comparative Analysis of the Efficacy between Transumbilical Single-port Laparoscopy and Conventional Laparoscopy for Ovarian Cystectomy

目的:分析经脐单孔腹腔镜与传统腹腔镜行卵巢囊肿剥除术的临床效果差异及对卵巢储备功能的影响。方法:选择2018年5月至2020年7月我院因卵巢囊肿行囊肿剥除术患者共173例,分为观察组(经脐单孔腹腔镜手术组)82例、对照组(传统腹腔镜手术组)91例,比较两组的术中及术后情况,包括手术时间、术中出血量、卵巢囊肿腹腔内破裂情况、术后肛门排气时间、术后住院时间、手术并发症及术后24小时疼痛视觉模拟评分(VAS)、术后3个月患者切口美观满意度评分,同时比较两组术前、术后卵巢储备情况,包括抗苗勒管激素(AMH)、黄体生成素(LH)、卵泡刺激素(FSH)及窦卵泡计数(AFC)。结果:观察组术后肛门排气时间缩短、术后住院时间减少,术后24小时VAS降低、术后切口美观满意度评分升高,两组差异有统计学意义(P<0.05);两组手术时间、术中出血量、卵巢囊肿腹腔内破裂率差异无统计学意义(P>0.05);两组术后1个月AMH均较术前降低,LH、FSH较术前升高,差异有统计学意义(P<0.05);术后3个月血清AMH、LH、FSH水平及AFC数目与术前差异无统计学意义(P>0.05),两组间比较差异无统计学意义(P>0.05)。结论:单孔腹腔镜手术在卵巢囊肿剔除术中可以减轻患者术后疼痛、促进术后快速康复、提高患者术后满意度,并且对卵巢储备功能影响不劣于传统腹腔镜手术。

Objective:To analysis the efficacy between transumbilical single-port laparoscopy and conventional laparoscopy in ovarian cystectomy.Methods:Data of 173 patients with ovarian cyst were collected in Wenjiang District People's Hospital from May 2018 to July 2020.82 cases underwent transumbilicalsingle-portlaparoscopy were assigned into observation group,the remaining 91 cases underwenttraditional laparoscopywere intocontrol group.Main measurements included operative time,intraoperative blood-loss,intra-abdominal rupture of ovarian cysts,postoperative exhaust time,postoperative hospital stay,surgical complications,and visual analogue scores of 24 hours postoperative pain,patients incision aesthetic satisfaction CS score 3 months after surgery and preoperative and postoperative ovarian reserve function.Results:Compared with control group,shorter postoperative exhaust time(P<0.05)and postoperative hospital stay(P<0.05),lower VAS at 24 hours postoperatively(P<0.05),higher postoperative CS score(P<0.05)were observed inobservation group.There was no significant difference in operation time,intraoperative blood loss,and intra-abdominal rupture rate of ovarian cysts between the two groups(P>0.05).TheAMH of the two groups was lower than that before the operation at 1 month after operation,and the LH and FSH were higher than that before the operation(P<0.05).Serum levels of AMH,LH,FSH and the number of AFC at 3 months after operation were not significantly different from those before operation(P>0.05),and there was no significant difference between the two groups(P>0.05).Conclusions:Single-port laparoscopy for ovarian cystectomy could reduce postoperative pain,promote rapid postoperative recovery,improve postoperative satisfaction of patients,and the effect on ovarian reserve is not inferior to traditional laparoscopic surgery.