悬吊法免气腹单孔腹腔镜和气腹腹腔镜手术治疗卵巢肿瘤的效果比较

Efficacy of gasless single incision laparoscopic surgery using an abdominal wall lifting technique versus laparoscopic surgery using pneumoperitoneum for ovarian cancer

目的探讨悬吊法免气腹单孔腹腔镜和气腹腹腔镜手术治疗卵巢肿瘤的临床效果。方法选取2018年8月至2020年8月间上海中医药大学附属曙光医院收治的112例卵巢肿瘤患者,采用随机数字表法分为免气腹组和常规组,每组56例。免气腹组采用悬吊法免气腹单孔腹腔镜手术治疗,常规组患者采用传统气腹腹腔镜手术治疗,比较两组患者手术指标、并发症及卵巢功能恢复情况。结果两组患者舒张压、收缩压、动脉血氧饱和度和pH指标比较,差异无统计学意义(P>0.05);免气腹组患者动脉血氧分压、动脉血二氧化碳分压和剩余碱指标均优于常规组,差异均有统计学意义(均P<0.05)。免气腹组患者手术时间及住院时间均短于常规组,术中出血量少于常规组,差异均有统计学意义(均P<0.05)。免气腹组患者术后排气时间和体温恢复时间均短于常规组,术后24h引流量少于常规组,术后肩痛发生情况少于常规组,差异均有统计学意义(均P<0.05)。随访12个月,两组患者血清卵泡刺激素、雌二醇水平及卵泡个数比较,差异均无统计学意义(P>0.05)。结论悬吊法免气腹单孔腹腔镜手术治疗卵巢肿瘤效果好,术后恢复快,值得临床推广。

Objective To compare the therapeutic efficacy of gasless single incision laparoscopic surgery using an abdominal wall lifting technique versus laparoscopic surgery using pneumoperitoneum for ovarian cancer.Methods A total of 112 patients with ovarian cancer were selected at Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2018 to August 2020.They were divided into a gasless laparoscopic surgery group and a conventional laparoscopic surgery group with 56 patients each using random number table method.The gasless laparoscopic surgery group underwent gasless single incision laparoscopic surgery and the conventional laparoscopic surgery group underwent conventional laparoscopic surgery using pneumoperitoneum.The operation indicators,the occurrence of complications,as well as the recovery of ovarian function were compared between the two groups.Results There was no significant difference in diastolic and systolic blood pressure,SaO_(2) and pH value between the two groups(P>0.05).PaO_(2),PaCO_(2) and base excess were better in the pneumoperitoneum free group than in the conventional group(all P<0.05).The duration of operation and length of hospital stay were shorter and the intraoperative blood loss was less in the pneumoperitoneum free group than in the conventional laparoscopic surgery group(all P<0.05).Time to postoperative exhaust and time to temperature recovery were shorter in the pneumoperitoneum free group than in the conventional group(all P<0.05).Postoperative drainage volume was less in the pneumoperitoneum free group than in the conventional group at 24 h after the surgery(all P<0.05).Moreover,the incidence of postoperative shoulder pain was less in the pneumoperitoneum free group than in the conventional group(P<0.05).Conclusion Gasless single incision laparoscopic surgery using an abdominal wall lifting technique shows good efficacy for ovarian cancer with good postoperative recovery.It is worthy of clinical promotion.