经脐单切口筋膜平台腹腔镜下卵巢囊肿剥除的疗效分析

Analysis of the curative effect of transumbilical single-incision laparoscopy with fascial platform for ovarian cystectomy

目的探讨经脐单切口筋膜平台腹腔镜下卵巢囊肿剥除的安全性和疗效。方法回顾性分析2018年6月至2021年12月福建省妇幼保健院105例行腹腔镜下卵巢囊肿剥除患者的临床资料。其中,行经脐单切口筋膜平台腹腔镜下卵巢囊肿剥除45例(观察组),行多孔腹腔镜下卵巢囊肿剥除60例(对照组)。记录手术时间、术中出血量、中转开腹、囊肿破裂、副损伤、肛门排气时间、术后住院时间、住院费用、术后感染等。于术后6和24 h采用面部表情量表(FRS)评价疼痛情况;于术后2个月采用Kiyak满意度量表评价切口满意度。结果两组患者均顺利完成手术,无中转开腹,未发生周围脏器副损伤。两组手术时间、术中出血量、术后住院时间、住院费用、囊肿破裂率和术后感染率比较差异无统计学意义(P>0.05);观察组肛门排气时间和术后6、12 h FRS评分明显小于对照组[(22.1±3.5)h比(23.9±3.8)h、1(0,2)分比2(1,4)分和1(0,1)分比1(0,2)分],切口满意度评分明显大于对照组[5(4,5)分比4(3,4)分],差异有统计学意义(P<0.05或<0.01)。结论经脐单切口筋膜平台腹腔镜下卵巢囊肿剥除手术安全可行,且切口隐蔽、患者满意度高,具有较好的临床应用价值。

Objective To investigate the safety and curative effect of transumbilical single-incision laparoscopy with fascial platform for ovarian cystectomy.Methods The clinical data of 105 patients underwent laparoscopy ovarian cystectomy in Fujian Maternity and Child Health Hospital from June 2018 to December 2021 were retrospectively analyzed.Among them,45 patients underwent transumbilical single-incision laparoscopy with fascial platform for ovarian cystectomy(observation group),and 60 patients underwent multi-port laparoscopy for ovarian cystectomy(control group).The operative time,intraoperative bleeding,conversion to open surgery,cyst rupture,surgical collateral injury,postoperative exhaust time,postoperative hospital stays,hospitalization cost and postoperative infection,etc were recorded.The face rating scale(FRS)was used to evaluate the pain at 6 and 24 h after operation;the incision satisfaction was evaluated by the Kiyak satisfaction scale at 2 months after operation.Results The operation was carried out successfully in both groups without surgical collateral injury or conversion to open surgery.There were no significant differences in operative time,intraoperative bleeding,postoperative hospital stays,hospitalization cost,cyst rupture rate and postoperative infection rate between 2 groups(P>0.05);the postoperative exhaust time and FRS 6 and 24 h after operation in observation group were significantly less than those in control group:(22.1±3.5)h vs.(23.9±3.8)h,1(0,2)scores vs.2(1,4)scores and 1(0,1)scores vs.1(0,2)scores,the incision satisfaction score was significantly higher than that in control group:5(4,5)scores vs.4(3,4)scores,and there were statistical differences(P<0.05 or<0.01).Conclusions Transumbilical single-incision laparoscopy with fascial platform for ovarian cystectomy is safe and feasible,with concealed incision and high patient satisfaction,and has good clinical application value.