创新型软性Trocar经脐单孔腹腔镜卵巢囊肿剥除术的临床疗效

Clinical efficacy of single port laparoscopic ovarian cystectomy with innovative soft Trocar

目的探讨创新型软性Trocar经脐单孔腹腔镜卵巢囊肿剥除术的临床疗效。方法回顾性分析2020年9月—2021年3月解放军总医院第一医学中心收治的76例卵巢囊肿患者的临床资料,按手术方法不同将其分为观察组(38例)和对照组(38例)。观察组行创新型软Trocar经脐单孔入路腹腔镜下卵巢囊肿剥除术,对照组为传统入路腹腔镜下卵巢囊肿剥除术。比较两组患者的临床治疗相关指标、术后美观满意度、卵巢功能指标等方面的差异。结果观察组患者囊液外漏率(5.26%)明显低于对照组(18.42%),术后首次排气时间(11.35±0.78)h明显短于对照组(15.83±1.19)h,差异具有统计学意义(P<0.05);两组患者手术时间观察组(20.68±3.39)min、对照组(24.10±3.62)min、术中出血量观察组(24.36±1.31)h、对照组(25.92±2.41)h及住院时间观察组(3.21±1.52)d、对照组(4.19±1.71)d比较,差异无统计学意义(P>0.05)。术前两组患者LH[观察组(10.30±1.8)mIU/mL,对照组(9.91±2.8)mIU/mL]、FSH[观察组(7.46±1.8)mIU/mL,对照组(7.13±1.7)mIU/mL]均低于术后1个月水平[LH:观察组(12.24±4.1)mIU/mL,对照组(14.92±2.7)mIU/mL;FSH:观察组(10.00±1.5)mIU/mL,对照组(11.51±1.6)mIU/mL]。而术前E2水平[观察组(318.9±36.9)μmol/L,对照组(310.4±39.0)μmol/L]均高于术后1个月[观察组(291.6±33.7)μmol/L,对照组(264.5±32.1)μmol/L],差异有统计学意义(P<0.05);术后1个月,观察组LH(12.24±4.1)mIU/mL、FSH(10.00±1.5)mIU/mL水平低于对照组LH(14.92±2.7)mIU/mL、FSH(11.51±1.6)mIU/mL,E2水平观察组(291.6±33.7)μmol/L高于对照组(264.5±32.1)μmol/L,差异有统计学意义(P<0.05);术前两组AMH[观察组(1.93±0.46)ng/mL,对照组(1.91±0.44)ng/mL]水平比较,差异无统计学意义(P>0.05);术后观察组AMH(1.67±0.36)ng/mL水平优于对照组(1.42±0.3ng/mL),差异有统计学意义(P<0.05)。观察组术后3个月美观满意度(98.8±2.9)较对照组高(82.9±4.3),差异有统计学意义(P<0.05)。结论创新型软性Trocar经脐单孔腹腔镜卵巢囊肿剥除术囊液外漏率低,术后恢复快、疼痛轻、美观度高,对患者卵巢功能损伤小,是安全、可行的,值得在临床推广使用。

Objective To investigate the clinical efficacy of single port laparoscopic Ovarian cystectomy with innovative soft Trocar.Methods A retrospective analysis of the clinical data of 76 patients with ovarian cysts admitted to the First Medical Center of the PLA General Hospital from September 2020 to March 2021,according to different surgical methods,they were divided into observation group(38 cases)and control group(38 cases).Observation group underwent innovative soft Trocar transumbilical single port laparoscopic ovarian cystectomy,the control group underwent traditional laparoscopic ovarian cystectomy.Compared the differences in clinical treatment-related indicators,postoperative aesthetic satisfaction,and ovarian function indicators between the two groups of patients.Results The leakage rate of cystic fluid(5.26%)of the observation group was substantially below than that(18.42%)of the control group,the first exhaust time after operation(11.35±0.78)h was significantly shorter than that(15.83±1.19)h of the control group,with significant difference(P<0.05);Comparison of length of operation,peroperative bleeding and duration of hospital stays between the two groups,difference with no significant(P>0.05).The LH[observation group(10.30±1.8)mIU/mL control group(9.91±2.8)mIU/mL]and FSH[observation group(7.46±1.8)mIU/mL control group(7.13±1.7)mIU/mL]of the two groups of patients before operation were lower than the level[LH:observation group(12.24±4.1)mIU/mL control group(14.92±2.7)mIU/mL;FSH:observation group(10.00±1.5)mIU/mL control group(11.51±1.6)mIU/mL]of 1 month after operation,but the preoperative E2 level in observation group(291.6±33.7)μmol/L was higher than that of the control group(264.5±32.1)μmol/L of 1 month after operation,the difference was statistically significant(P<0.05).There was no noticeable difference in the two groups of AMH levels[observation group(1.93±0.46)ng/mL,control group(1.91±0.44)ng/mL]before operation(P>0.05);The level of AMH in the observationgroup(1.67±0.36)ng/mL was better than that in the control group(1.42±0.3)ng/mL after operation,the difference was statistically significant(P<0.05).The observation group has higher aesthetic satisfaction(98.8±2.9)%than the control group(82.9±4.3)%at 3 months after surgery,with significant difference(P<0.05).Conclusion The single port laparoscopic Ovarian cystectomy with innovative soft Trocar has low leakage rate of sac fluid,fast recovery after surgery,light postoperative pain,higher aesthetics,less damage to the patient’s ovarian function,low hospitalization costs,is safe and feasible,worthy of clinical promotion and use.