经脐单孔腹腔镜下卵巢囊肿剥除术治疗卵巢囊肿对术后疼痛及卵巢储备功能的影响

Effect of Transumbilical Laparoendoscopic Single-site Surgery Ovarian Cystectomy on Postoperative Pain and Ovarian Reserve Function in the Treatment of Ovarian Cysts

目的:研究经脐单孔腹腔镜(TU-LESS)下卵巢囊肿剥除术治疗卵巢囊肿对术后疼痛及卵巢储备功能的影响。方法:以2019年1月-2022年1月樟树市人民医院收治的80例卵巢囊肿患者为对象进行研究,根据系统化随机法将其分为单孔组(n=40)和三孔组(n=40)。单孔组予TU-LESS卵巢囊肿剥除术,三孔组予传统三孔腹腔镜卵巢囊肿剥除术。比较两组围手术期指标(术中出血量、术后排气时间、住院时间、术中卵巢囊肿破裂率)。使用视觉模拟评分法(VAS)评分比较两组术后1、3 d疼痛程度。记录围手术期并发症。比较术后1、3个月两组血清激素[促黄体生成素(LH)、雌二醇(E2)]变化。术后随访6个月,统计两组卵巢囊肿的复发情况。结果:单孔组术中出血量少于三孔组,术后排气时间、住院时间均短于三孔组,术后1、3 d VAS评分均低于三孔组(P<0.05)。术后3个月,两组E2水平较术后1个月均升高(P<0.05),且单孔组高于三孔组(P<0.05);两组LH水平较术后1个月均降低(P<0.05),且单孔组低于三孔组(P<0.05)。两组卵巢囊肿破裂率、围手术期并发症发生情况及卵巢囊肿复发情况比较,差异均无统计学意义(P>0.05)。结论:相较于三孔腹腔镜手术,TU-LESS卵巢囊肿剥除术治疗卵巢囊肿具有术中创伤小、恢复快等优点,对减少患者术后疼痛感及控制手术对卵巢储备功能损伤有利。

Objective:To study the effect of transumbilical laparoendoscopic single-site surgery(TU-LESS)ovarian cystectomy on postoperative pain and ovarian reserve function in the treatment of ovarian cysts.Method:A total of 80 patients with ovarian cysts who were admitted to Zhangshu People's Hospital from January 2019 to January 2022 were selected as object of study.The patients were divided into the single-port group(n=40)and the threeport group(n=40)according to the systematic random method.The single-port group was given TU-LESS ovarian cystectomy,while the three-port group adopted traditional three-port laparoscopic ovarian cystectomy.The perioperative indicators(intraoperative blood loss,postoperative exhaust time,hospital stay,intraoperative ovarian cyst rupture rate)were compared between the two groups.Visual analogue scale(VAS)score was used to compare the pain degree between the two groups at 1 day and 3 days after surgery,and perioperative complications were recorded.The changes in serum hormones[luteinizing hormone(LH),estradiol(E_(2))]were compared at 1 month and 3 months after surgery.At 6 months of follow-up after surgery,the recurrence of ovarian cysts in the two groups was counted.Result:The intraoperative blood loss in the single-port group was less than that in the three-port group,postoperative exhaust time,hospital stay of patients in the single-port group were shorter than those in the three-port group,the VAS scores 1 day and 3 days after surgery were lower than those in the three-port group(P<0.05).At 3 months after surgery,the E_(2) level in both groups was increased compared with that at 1 month after surgery(P<0.05),and the level in single-port group was higher than that in three-port group(P<0.05);the LH levels of the two groups were reduced compared with those at 1 month after surgery(P<0.05),and the level in single-port group was lower compared to three-port group(P<0.05).The differences in ovarian cyst rupture rate,perioperative complications and ovarian cyst recurrence between the two groups were not statistically significant(P>0.05).Conclusion:Compared with three-port laparoscopic surgery,TU-LESS ovarian cystectomy for ovarian cysts has the advantages of smaller intraoperative trauma and faster recovery,and the latter one is more beneficial to reducing the postoperative pain and controlling the damage of ovarian reserve function by surgery.