腹腔镜手术不同入路切口对卵巢成熟性畸胎瘤患者术后胃肠功能的影响观察

Influence of laparoscopic surgery via different approaches on postoperative gastrointestinal function in patients with mature ovarian teratomas

目的探讨腹腔镜手术不同入路切口对卵巢成熟性畸胎瘤患者术后胃肠功能的影响。方法选取2021年7月至2023年1月许昌市中心医院收治的卵巢成熟性畸胎瘤患者92例,根据腹腔镜不同入路切口分为A组(脐轮上缘弧形单切口)、B组(神阙穴纵形单切口)、C组(多孔),比较3组患者围手术期指标(手术时间、术中出血量、术后住院时间)、术后胃肠功能恢复情况(排气时间、肠鸣音恢复时间、排便时间)、卵巢功能指标[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、抗米勒管激素(AMH)]水平以及术后并发症。结果A、C组手术时间低于B组(P<0.05),术中出血量由高到低分别为A组>B组>C组,住院时间差异无统计学意义(P>0.05);排气时间、肠鸣音恢复时间、排便时间由高到低分别为C组>A组>B组(P<0.05);3组术后3个月内FSH、LH、E2、AMH和术后并发症发生率差异无统计学意义(P>0.05)。结论卵巢成熟性畸胎瘤患者采用在神阙穴取纵行单切口的腹腔镜下卵巢瘤剥除术能够在术后更快恢复胃肠功能,对卵巢功能影响较小,术后并发症发生率低。

Objective To explore the influence of laparoscopic surgery via different approaches on postoperative gastrointestinal function in patients with mature ovarian teratomas.Methods Totally 92 patients with mature ovarian teratomas admitted to Xuchang Central Hospital were selected from July 2021 to January 2023.According to different laparoscopic approaches,they were divided into group A(curved single incision at the upper edge of the umbilical wheel),group B(longitudinal single incision at Shenque acupoint)and group C(multi-port).The perioperative indicators(surgical time,intraoperative blood loss volume,postoperative hospital stay),postoperative gastrointestinal function recovery status(exhaust time,recovery time of bowel sounds,defecation time),ovarian function indicators[follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_2),anti-Mullerian hormone(AMH)]and postoperative complications were compared among the three groups of patients.Results The surgical time in group A and group C was shorter than that in group B(P<0.05),and the intraoperative blood loss volume from high to low was shown as group A>group B>group C,and there was no statistical significance in the postoperative hospital stay among the three groups(P>0.05).The exhaust time,recovery time of bowel sounds and defecation time from high to low were manifested as group C>group A>group B(P<0.05).There were no statistical differences in the levels of FSH,LH,E_2,AMH within 3 months after surgery and the incidence rates of postoperative complications(P>0.05).Conclusion Laparoscopic ovarian tumor removal with longitudinal single incision at Shenque acupoint for patients with mature ovarian teratomas can restore gastrointestinal function more quickly after surgery,and it has smaller impact on ovarian function and has low incidence rates of postoperative complications.