普通器械和自制简易Port平台的经脐单孔腹腔镜技术在401例妇科单病种疾病中的应用

Application of transumbilical single-port laparoscopic technique with common instruments and self-made simple Port platform in 401 cases of single gynecological diseases

目的 探讨普通器械和自制简易Port平台的经脐单孔腹腔镜技术在401例妇科单病种疾病中的安全性及可行性。方法 回顾性分析2018年10月至2020年11月于本院行普通器械和自制简易Port平台的经脐单孔腹腔镜手术401例患者(研究组)的临床资料,其中异位妊娠手术294例,卵巢囊肿剥除术76例,子宫肌瘤剔除术31例,另选取同期同样病种常规腹腔镜手术患者431例作为对照组。比较两组手术时间、术中出血量、术后肛门排气恢复时间、术后24 h视觉模拟评分法(VAS)评分、术后身体意向问卷表(BIQ)中体象量表(BIS)评分、美容(CS)评分、住院时间、住院费用及手术并发症。结果 两组均顺利完成手术,且术后均无相关并发症。两组异位妊娠术中出血量、住院费用比较差异无统计学意义;研究组术后VAS评分、BIS评分均低于对照组,CS评分较高于对照组,手术时间长于对照组,术中出血量少于对照组,肛门排气时间、住院时间均短于对照组(P<0.05)。研究组卵巢囊肿患者手术时间长于对照组,术中出血量多于对照组,肛门排气时间、住院时间短于对照组,术后VAS评分、BIS评分均低于对照组,CS评分高于对照组(P<0.05),两组住院费用比较差异无统计学意义。研究组子宫肌瘤剥除患者手术时间长于对照组(P<0.05),肛门排气恢复、住院时间均短于对照组,术后VAS评分、BIS评分均低于对照组,CS评分高于对照组(P<0.05),两组术中出血量、住院费用比较差异无统计学意义。结论 普通器械和自制简易Port平台的经脐单孔腹腔镜手术在妇科手术中具有一定的安全性及可行性,较常规的腹腔镜手术不增加住院费用,符合单病种费用范围,并且具有更好的美容效果,且术后疼痛轻、康复快等优点,值得临床推广应用。

Objective To explore the safety and feasibility of transumbilical single-port laparoscopic technique with common instruments and self-made simple Port platform in 401 cases of single gynecological diseases. Methods The clinical data of 401 patients who underwent transumbilical single-port laparoscopic surgery with common instruments and self-made simple port platform in our hospital from October 2018 to November2020 were retrospectively analyzed(study group), including 294 cases of ectopic pregnancy surgery, 76 cases of ovarian cyst removal and 31 cases of hysteromyomectomy. At the same time, 431 patients with the same disease were selected as the control group. The operation time, amount of intraoperative bleeding, recovery time of postoperative anal exhaust, 24 h visual analogue scale(VAS) score, body image scale(BIS) score in postoperative body intention questionnaire(BIQ), cosmetology(CS) score, hospitalization time, hospitalization costs and surgical complications were compared between the two groups. Results The operation was successfully completed in both groups, and there were no postoperative complications. There was no significant difference in hospitalization costs between the two groups of patients with ectopic pregnancy, the postoperative VAS score and BIS score of the study group were lower than those of the control group, the CS score was higher than that of the control group, the operation time was longer than that of the control group, the intraoperative blood loss was less than that of the control group, and the anal exhaust time and hospitalization time were shorter than those of the control group(P<0.05). The operation time of patients with ovarian cyst in the study group was longer than that in the control group, the intraoperative blood output was more than that in the control group, the anal exhaust time and hospitalization time were less than those in the control group, the postoperative VAS and BIS scores were lower than those in the control group, and the CS score was higher than that in the control group(P<0.05), there was no significant difference in hospitalization costs between the two groups. The operation time of myomectomy patients in the study group was longer than that in the control group(P<0.05), the recovery of anal exhaust and the length of hospitalization time were shorter than those in the control group, the postoperative VAS score and BIS score were lower than those in the control group, and the CS score was higher than the control group(P<0.05), there was no significant difference in intraoperative blood loss and hospitalization cost ratio between the two groups. Conclusion Transumbilical single-port laparoscopic surgery with common instruments and self-made simple Port platform has certain safety and feasibility in gynecological surgery. Compared with conventional laparoscopic surgery, it does not increase hospitalization costs, conforms to the cost range of single disease, and has better cosmetic effect, less postoperative pain and faster recovery, which is worthy of clinical application.