Comparision of modified and conventional delta-shaped gastroduodenostomy in totally laparoscopic surgery

AIM: To evaluate the safety and feasibility of a modified delta-shaped gastroduodenostomy (DSG) in totally laparoscopic distal gastrectomy (TLDG).

Effect of modified laparoscopic salpingectomy on ovarian reserve:Changes in the serum antimüllerian hormone levels

Objective:To retrospectively estimate the impact of modified laparoscopic salpingectomy on the ovarian reserve in infertile women.Methods:There were 74 infertile women undergone modified laparoscopic salpingectomy from June 2016 to January 2017,and their levels of serum antimüllerian hormone,basal follicle-stimulating hormone and estradiol were reviewed retrospectively.Results:No significant change was detected in serum antimüllerian hormone at 3 months after surgery compared to preoperative level(p=0.857).Similar changes were observed for the basal follicle-stimulating hormone(p=0.102)and estradiol(p=0.233)level.Conclusions:Our results revealed that modified laparoscopic salpingectomy might be a valuable treatment for hydrosalpinx before in vitro fertilization.

Modified transperitoneal laparoscopic radical prostatectomy:technique and clinical outcomes

Objective To evaluate the technique and clinical outcomes of modified transperitoneal laparoscopic radical prostatectomy. Methods A total of 105 patients received the operation with ages ranging from 51 to 73 years from January 2008 to June 2010. Mean level of serum prostate specific antigen was 13. 6 μg /L and

Overview of single-port laparoscopic surgery for colorectal cancers: Past, present, and the future

Single-port laparoscopic surgery (SPLS) is implemented through a tailored minimal single incision through which a number of laparoscopic instruments access. Introduction of operation-customized port system, utilization of a camera without a separate external light, and instruments with different lengths has brought the favorable environment for SPLS. However, performing SPLS still creates several hardships compared to multiport laparoscopic surgery; a single-port system inevitably leads to clashing of surgical instruments due to crowding. To overcome such difficulties, investigators has developed novel concepts and maneuvers, including the concept of inverse triangulation and the maneuvers of pivoting, spreading out dissection, hanging suture, and transluminal traction. The final destination of SPLS is expected to be a completely seamless operation, maximizing the minimal invasiveness. Specimen extraction through the umbilicus can undermine cosmesis by inducing a larger incision. Therefore, hybrid laparoscopic technique, which combined laparoscopic surgical technique with natural orifice specimen extraction (NOSE) - i.e., transvaginal or transanal route-, has been developed. SPLS and NOSE seemed to be the best combination in pursuit of minimal invasiveness. In the near future, robotic SPLS with natural orifice transluminal endoscopic surgery’s way of specimen extraction seems to be pursued. It is expected to provide a completely or nearly complete seamless operation regardless of location of the lesion in the abdomen.

A Prospective Study Comparing Quality of Life and Cosmetic Results between Single-Port and Conventional Laparoscopic Cholecystectomy

Background: Multiple studies from the last five years have demonstrated that single-incision laparoscopic surgery cholecystectomy (SILS) is not only feasible but also produces a result comparable with that of conventional laparoscopic cholecystectomy (CLC). Methods and results: In this bicentric study, we used the Short Form (36) (SF-36) and Nottingham Health Profile (NHP) surveys to estimate and compare the post-operative quality of life up to the 28th post-operative day for 66 patients who had undergone either CLC (n = 32) or SILS (n = 34). Additionally, we investigated patient satisfaction with the cosmetic results after one year. The curves summarizing the eight sections in the physical sum scale and in the mental sum scale (SF-36) were the same within the confidence interval with a confidence level of 95%. Thus, post-operative quality of life could be assumed to be equivalent for the two groups. Evaluation of the NHP survey produced similar results. The perceived cosmetic results were significantly better for the SILS group (1.3 on a scale of 1 - 5 with 1 being the best) than for the CLC group (1.9) (p = 0.016). Conclusions: This study did not demonstrate better quality of life for the single-port procedure as it had been expected. Instead, the single-port procedure produced subjectively better cosmetic results.

Feasibility of single-incision laparoscopic cholecystectomy for acute cholecystitis

AIM: To assess the safety of single-incision laparoscopic cholecystectomy(SILC) for acute cholecystitis.METHODS: All patients who underwent SILC at Sano Hospital(Kobe, Japan) between January 2010 and December 2014 were included in this retrospective study. Clinical data related to patient characteristics and surgical outcomes were collected from medical records. The parameters for assessing the safety of the procedure included operative time, volume of blood loss, achievement of the critical view of safety, use of additional trocars, conversion to laparotomy, intraoperative and postoperative complications, and duration of postoperative hospital stay. Patient backgrounds were statistically compared between those with and without conversion to laparotomy.RESULTS: A total of 100 patients underwent SILC for acute cholecystitis during the period. Preoperative endoscopic treatment was performed for suspected choledocholithiasis in 41 patients(41%). The mean time from onset of acute cholecystitis was 7.7 d. According to the Updated Tokyo Guidelines(TG13) for the severity of cholecystitis, 86 and 14 patients had grade Ⅰ and grade Ⅱ acute cholecystitis, respectively. The mean operative time was 87.4 min. The mean estimated blood loss was 80.6 mL. The critical view of safety was obtained in 89 patients(89%). Conversion laparotomy was performed in 12 patients(12%). Postoperative complications of Clavien-Dindo grade Ⅲ or greater were observed in 4 patients(4%). The mean duration of postoperative hospital stay was 5.7 d. Patients converted from SILC to laparotomy tended to have higher days after onset.CONCLUSION: SILC is feasible for acute cholecystitis; in addition, early surgical intervention may reduce the risk of laparotomy conversion.

Single port laparoscopic liver surgery:A minireview

Nowadays,the trend is to perform surgeries with"scarless"incisions.In light of this,the single-port laparoscopic surgery(SPLS)technique is rapidly becoming widespread due to its lack of invasiveness and its cosmetic advantages,as the only entry point is usually hidden in the umbilicus.The interest in"scarless"liver resections did not grow as rapidly as the interest in other scarless surgeries.Hepatopancreatobiliary surgeons are reluctant to operate a malignant lesion through a narrowincision with limited exposure.There are concerns over adverse oncological outcomes for single-port laparoscopic liver resections(SPL-LR)for hepatocellular carcinoma or metastatic colorectal cancer.In addition,getting familiar with using the operating instruments through a narrow incision with limited exposure is very challenging.In this article,we reviewed the published literature to describe history,indications,contraindications,ideal patients for new beginners,technical difficulty,advantages,disadvantages,oncological concern and the future of SPL-LR.

Present laparoscopic surgery for colorectal cancer in Japan

In many clinical studies,laparoscopic surgery(LS) for colon cancer has been shown to be less invasive than open surgery(OS) while maintaining similar safety.Furthermore,there are no significant differences between LS and OS in long-term outcomes.Thus,LS has been accepted as one of the standard treatments for colon cancer.In the treatments of rectal cancer as well,LS has achieved favorable outcomes,with many reports showing long-term outcomes comparable to those of OS.Furthermore,the magnification in laparoscopy improves visualization in the pelvic cavity and facilitates precise manipulation,as well as providing excellent educational effects.For these reasons,rectal cancer has seemed to be well indicated for LS,as has been colon cancer.The indication for LS in the treatment of locally advanced rectal cancer,which is relatively unresectable(e.g.,cancer invading other organs),remains an open issue.In recent years,new techniques such as singleport and robotic surgery have begun to be introduced for LS.Presently,various clinical studies in our country as well as in most Western countries have demonstrated that LS,with these new techniques,are gradually showing long-term outcomes.

Single port laparoscopic hysterectomy: Feasibility and safety

Objective: To evaluate the feasibility and safety of single-port laparoscopic hysterectomy comparing with multi-port laparoscopic hysterectomy in treatment of benign uterine diseases. Methods: Data were collected retrospectively by review of the medical records of 252 patients who underwent multi-port or single-port laparoscopic surgery for treatment of benign gynecologic diseases. Laparoscopy assisted vaginal hysterectomy (LAVH) was performed for single-port surgery and LAVH and total laparoscopic hysterectomy (TLH) were performed for multi-port surgery. Demographic variables were collected and analyzed by independent t-test and Pearson Chi-Square test. The primary outcome was analyzed by independent t-test and Fisher’s Exact test. Results: A longer operative time was observed in the multi-port surgery group compared with that of the single-port group (p < 0.05). No difference with respect to change of Hemoglobin between the preoperative level and that of the postoperative first day, the number of days from the operation to discharge, uterine weight, and the rate of laparotomy conversion and complications were observed between the two groups. Conclusion: Single-port laparoscopic hysterectomy for treatment of benign uterine diseases is a safe and feasible method.

Single-site laparoscopic partial nephrectomy: Where are we going?

AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed database to identify all publications relating to LESS-partial nephrectomy(PN).The research includes articles published from April 2008 to January 2014.We focused our attention only on articles in which were cited the single-site surgical technique(laparoscopic and robotic),tumour stage and grade,mean tumour size,intraoperative variables,blood loss and transfusion rate,length of postoperative stay and complication rates,Clavien classification,positive of surgical margins,pain assessment at discharge.RESULTS:A total of 9 studies were collected with 221patients included.The mean patients age was 62 years.The mean tumor size was 2.35 cm with a mean operative time of 181 min(range 111-270 min)and 58.3%were done by robot.The mean ischemia time was 23.6min.The 25.8%of patients underwent an unclamp LESS-PN.Mean estimated blood loss was 296 mL and median length of hospital stay was 4 d.The rate of severe post-operative complications(≥Clavien gradeⅢ)was 5.4%.Not all surgical series of LESS-PN or Robotic-LESS-PN shows conversion in Multiport Laparoscopic or Open Surgery.Regarding oncologic outcomes,surgical margins were positive 4%of patients(9/221),no distant or port-site metastases were recorded.CONCLUSION:LESS-PN and RLESS-PN are feasible and associated with reduced postoperative pain,shorter median hospital stay,shorter recovery time,and better cosmetic satisfaction without compromising surgical and oncological safety.

Short-term effects of modified ultrasonography in laparoscopic anatomical hepatectomy for hepatocellular carcinoma

Background and aims:Laparoscopic hepatectomy is challenging,and ultrasound guidance is an effective aid but lacks standardization.This study aimed to evaluate a modified approach for laparoscopic ultrasonography to enhance surgical outcomes.Methods:Between January 2020 and August 2023,122 patients who underwent real-time ultrasound-guided laparoscopic anatomical hepatectomy for hepatocellular carcinoma were enrolled and divided into modified and traditional ultrasonography groups.The modified ultrasound application comprised intraoperative protocol-based laparoscopic ultrasonography comprising application scenarios;standardized positions for the surgeon,trocar,and probe;and the resulting standardized sections for various laparoscopic liver resections.Clinical characteristics and perioperative outcomes were compared between the two groups.Subgroup analysis was performed and comprised techniques for modified duct structure identification and portal vein branch puncture;both techniques were used in fluorescence probe-mounted laparoscopic liver resection using negative and positive staining procedures,respectively.Results:The traditional and modified groups comprised 64 and 58 patients,respectively.The patients’background characteristics were not significantly different between the groups.Surgical duration(283.4 min vs.225.1 min;p<0.001),Pringle maneuver duration(47.4 min vs.39.5 min;p?0.014),bleeding volume(258.6 mL vs.174.8 mL;p?0.005),overall complication rate(31.3%vs.15.5%;p?0.041),and postoperative stay were significantly greater in the traditional vs.modified ultrasonography groups,respectively.The modified method positively affected the number of punctures,success rate of staining,intraoperative bleeding volume,and operation duration.Conclusions:Modified ultrasonography improves the safety and effectiveness of laparoscopic hepatectomy.Ultrasonography is pivotal,especially in fluorescence probe-assisted laparoscopic liver resection.

Single-port versus multi-port cholecystectomy for patients with acute cholecystitis: a retrospective comparative analysis

BACKGROUND: Trans-umbilical single-port laparoscopic cholecystectomy for chronic gallbladder disease is becoming increasingly accepted worldwide. But so far, no reports exist about the challenging single-port surgery for acute cholecystitis. The objective of this study was to describe our experience with single-port cholecystectomy in comparison to the conventional laparoscopic technique. METHODS: Between August 2008 and March 2010, 73 patients with symptomatic gallbladder disease and histopathological signs of acute cholecystitis underwent laparoscopic cholecystec- tomy at our institution. Thirty-six patients were operated on with the single-port technique (SP group) and the data were compared with a control group of 37 patients who were treated with the multi-port technique (MP group). RESULTS: The mean age in the SP group was 61.5 (range 21-81) years and in the MP group was 60 (range 21-94) (P=0.712). Gender, ASA status and BMI were not significantly different. The number of white blood cells was different before [SP: 9.2 (range 2.8-78.4); MP: 13.2 (range 4.4-28.6); P=0.001] and after the operation [SP: 7.8 (range 3.5-184.8); MP: 11.1 (range 5-20.8); P=0.002]. Mean operating time was 88 (range 34-174) minutes in the SP group vs 94 (range 39-209) minutes in the MP group (P=0.147). Four patients (5%) required conversion to an open procedure (SP: 1; MP: 3; P=0.320). During the follow- up period of 332 (range 29-570) days in the SP group and 428 (range 111-619) days in the MP group (P=0.044), eleven (15%) patients developed postoperative complications (P=0.745) and two patients in the SP group required reoperation (P=0.154). CONCLUSIONS: Trans-umbilical single-port cholecystectomy for beginning acute cholecystitis is feasible and the complicationrate is comparable with the standard multi-port operation. In spite of our good results, these operations are difficult to perform and should only be done in high-volume centers for laparoscopic surgery with experience in single-port surgery.

腹腔镜改良Soave短肌鞘术式治疗小儿先天性巨结肠的疗效、安全性及对排便功能的影响

目的 观察腹腔镜改良Soave短肌鞘术式治疗小儿先天性巨结肠(HD)的临床疗效、安全性及对排便功能的影响。方法 我院2018年1月~2023年5月收治的HD患儿91例,按照随机数字表法分为观察组(腹腔镜改良Soave短肌鞘术式,41例)和对照组(传统腹腔镜Soave巨结肠根治术,50例)。比较两组患儿的手术时间、术中出血量、术后排便时间、术后住院时间、切除肠管长度以及术前灌肠时间,比较两组患儿手术前后白细胞计数(WBC)和C反应蛋白(CRP)水平,比较两组患儿术后12小时、24小时、36小时、48小时的疼痛评分,比较两组患儿术后排便功能和术后并发症发生情况。结果 观察组患儿手术时间(134.07±22.08)分钟、术中出血量(5.17±0.87)ml、术后排便时间(2.10±0.32)天、术后住院时间(7.59±1.25)天、切除肠管长度(15.24±2.25)厘米以及术前灌肠时间(13.61±2.14)分钟均少于短于对照组[(159.78±25.44)分钟、(7.61±1.41)ml、(2.46±0.53)天、(10.59±1.84)天、(16.67±2.54)厘米、(16.44±2.57)分钟],差异有统计学意义(P<0.05);手术后两组患儿血清WBC、CRP水平均上升,但观察组血清WBC、CRP水平低于对照组,差异有统计学意义(P<0.05);观察组患儿在术后12小时、24小时、36小时、48小时的疼痛评分(3.42±0.69、3.17±0.64、2.52±0.58、2.06±0.53)均低于对照组(4.47±0.76、3.78±0.72、3.31±0.66、2.83±0.64),差异有统计学意义(P<0.05);两组患儿术后排便功能比较,差异无统计学意义(P>0.05);观察组患儿术后并发症总发生率为17.07%,低于对照组的34.00%,差异有统计学意义(P<0.05)。结论 应用腹腔镜改良Soave短肌鞘术治疗HD,可改善各临床指标和排便功能,缓解术后疼痛,降低感染程度,减少术后并发症,安全性更高。

改良经腹膜外腹腔镜全筋膜内根治性前列腺切除术对局限性前列腺癌患者勃起功能、尿流动力学的影响

目的探讨局限性前列腺癌(PCa)患者采用改良经腹膜外腹腔镜全筋膜内根治性前列腺切除术(RP)对其勃起功能、尿流动力学的改善效果。方法回顾性选取浙江中医药大学附属第一医院庆元分院2020年1月至2022年6月收治的局限性PCa患者82例,依据术中筋膜处理方式的不同分为对照组(41例)和观察组(41例)。两组均行经腹膜外腹腔镜RP,对照组术中给予常规筋膜间保留血管神经束,观察组术中给予改良全筋膜内切除。比较两组手术相关指标、勃起功能、尿流动力学指标、疼痛状况及并发症。结果两组手术时间、出血量、引流管留置时间、住院时间、切缘阳性占比比较,差异均无统计学意义(P>0.05)。术后6个月两组国际勃起功能指数-5(IIEF-5)评分相比术前均升高;观察组术后6个月IIEF-5评分及勃起功能恢复率高于对照组,视觉模拟评分法(VAS)评分低于对照组,差异具有统计学意义(P<0.05)。两组术后6个月最大膀胱容量(MBC)、最大尿道闭合压(MUCP)比术前升高,观察组高于对照组;术后6个月充盈期膀胱顺应性值(BC)、残余尿量(PVR)、逼尿肌不稳定率(DI)比术前降低,观察组低于对照组,差异均具有统计学意义(P<0.05)。观察组术后6个月随访的总并发症发生率低于对照组,差异具有统计学意义(P<0.05)。结论改良经腹膜外腹腔镜全筋膜内RP应用于局限性PCa患者可促进勃起功能恢复,减轻疼痛症状,调节尿流动力学指标水平,安全性良好。

腹腔镜胆囊切除术中改良结扎法的临床应用效果及安全性

目的:研究腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中改良结扎法的临床应用效果及安全性。方法:选取2022年1月—2023年12月北京市垂杨柳医院收治的98例LC患者。根据电脑编号奇偶数字法随机将其分为改良组(n=49)及传统组(n=49)。改良组LC中实施改良结扎法,传统组LC中实施传统结扎法。比较两组围手术期指标,并发症,术前1 d及术后3 d肝功能指标、炎症因子。结果:改良组手术时长短于传统组,差异有统计学意义(P<0.05)。两组腹腔出血、胆漏及切口感染发生率比较,差异无统计学意义(P>0.05)。术后3 d,两组丙氨酸转氨酶(alanine transaminase,ALT)、天冬氨酸转氨酶(aspartate transaminase,AST)及总胆红素(total bilirubin,TBIL)水平均高于术前1 d,改良组ALT、AST、TBIL水平均低于传统组,差异有统计学意义(P<0.05)。术后3 d,两组白细胞介素-6(interleukin-6,IL-6)、降钙素原(procalcitonin,PCT)及C反应蛋白(C-reactive protein,CRP)水平均高于术前1 d,改良组IL-6、PCT、CRP水平均低于传统组,差异有统计学意义(P<0.05)。结论:改良结扎法应用于LC中安全可行,且能减轻对患者肝功能与炎症反应的影响。

改良腹腔镜膀胱外输尿管再植术治疗原发性梗阻性巨输尿管

目的探讨改良腹腔镜膀胱外输尿管再植术治疗原发性梗阻性巨输尿管的临床效果。方法回顾性分析2020年12月~2023年10月改良腹腔镜膀胱外输尿管再植术(Lich-Gregoir法)治疗原发性梗阻性巨输尿管11例资料。年龄7个月~10岁5个月,(57.6±41.9)月。术中从膀胱后壁纵向建立隧道,并将新隧道的腹侧端作为输尿管吻合口。结果11例腹腔镜操作均获成功,无术中并发症,无中转开腹。手术时间105~145 min,(125.5±13.9)min。11例随访4~25个月,平均16个月。均无排尿困难、尿路感染。术后3~6个月输尿管远端最大径和肾积水均较术前明显减轻[输尿管远端最大径从(23.0±10.0)mm缩小至(5.2±3.4)mm(P=0.000),肾集合系统最大分离值从(35.2±21.1)mm缩小至(11.6±6.9)mm(P=0.001)]。结论改良腹腔镜膀胱外输尿管再植术操作简单,可作为儿童原发性梗阻性巨输尿管治疗方案之一。

全腹腔镜下食管空肠改良π形吻合术与食管空肠端侧吻合术在全胃切除术中的应用效果及安全性比较

目的比较全腹腔镜下全胃切除术中食管空肠改良π形吻合术与食管空肠端侧吻合术两种术式的临床效果和安全性。方法回顾性分析2020年3月至2023年2月在江苏省肿瘤医院择期行完全腹腔镜根治性全胃切除术的100例胃腺癌患者资料。根据术式不同分为改良π形吻合组与端侧吻合组,每组各50例,分别在全腹腔镜全胃切除术中选择食管空肠改良π形吻合术与食管空肠端侧吻合术。比较两组患者的手术指标(手术出血量、手术时间、切口长度以及吻合时间)、术后康复指标(术后排气时间、术后首次进食以及引流管撤除时间、住院时间)、疼痛指标[术后6 h、术后1 d、术后3 d视觉模拟评分法(VAS)]、病理分期(TNM分期)以及围手术期并发症(肺部感染、吻合口狭窄、切口感染、胃食管反流)发生情况。结果两组患者的手术出血量和手术时间比较,差异均无统计学意义(P>0.05);改良π形吻合组患者的切口长度和吻合时间分别为(5.29±1.48)cm、(31.44±7.96)min,均明显短于端侧吻合组[(11.06±1.33)cm、(43.86±6.51)min],差异均有统计学意义(P<0.05)。两组患者的术后排气时间、术后首次进食时间、引流管拔管时间、住院时间比较,差异均无统计学意义(P>0.05)。术后6 h,两组患者的疼痛VAS评分比较,差异无统计学意义(P>0.05);术后1 d、术后3 d,改良π形吻合组患者的疼痛VAS评分分别为(5.02±0.71)、(3.08±0.87)分,均明显低于端侧吻合组[(5.97±0.89)、(5.94±1.04)分],差异均有统计学意义(P<0.05)。两组术后病理分期均相比术前明显改善,组内比较差异有统计学意义(P<0.05);两组患者的术前、术后病理分期组间比较,差异均无统计学意义(P>0.05)。两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论全腹腔镜全胃切除术中选择食管空肠改良π形吻合术的临床预后良好,相比端侧吻合术的术源性创伤更小,手术时间更短,对于患者术后疼痛控制有更好的效果,术后并发症发生率也未发现明显升高,值得临床推广应用。

改良后路径腹腔镜手术对宫颈癌的疗效及对其血清指标及预后的影响分析

目的探讨改良后路径腹腔镜手术对宫颈癌的疗效及对其血清指标及预后的影响。方法选取106例宫颈癌患者,根据腹腔镜手术路径不同分为2组。研究组50例,采用改良后路LRH,而对照组56例,则采用传统LRH,比较2组患者的临床疗效。结果两组的手术时间、淋巴结清扫数目等比较均无差异(P>0.05),而研究组的术中出血量及术后住院时间均较对照组优(P<0.05);两组术后并发症发生率比较无差异(P>0.05);术后两组的炎性指标均较术前升高,且对照组更甚(P<0.05);术后1年,两组总生存率及复发率比较无差异(P>0.05)。结论改良后路径腹腔镜手术对宫颈癌患者的疗效更佳,不仅可减少术中出血,减轻患者的炎性反应,同时不增加其术后并发症发生率及不影响预后,值得临床推广应用。

回肠末端改良自闭式造口术治疗低位直肠癌腹腔镜保肛手术患者的疗效及安全性

目的探讨回肠末端改良自闭式造口术治疗低位直肠癌腹腔镜保肛手术患者的疗效及安全性。方法选取80例低位直肠癌患者,均接受腹腔镜保肛手术,根据造口方式的不同分为对照组(n=50)和改良组(n=30),对照组患者给予回肠末端袢式造口术,改良组患者给予回肠末端改良自闭式造口术。比较两组患者的术中相关指标、术后相关指标及并发症发生情况。结果两组患者手术时间、造口时间、术中出血量、肠功能恢复时间、首次进食时间比较,差异均无统计学意义(P﹥0.05),改良组患者住院时间明显短于对照组,住院费用明显低于对照组,差异均有统计学意义(P﹤0.01)。两组患者住院期间及远期并发症总发生率比较,差异均无统计学意义(P﹥0.05)。结论回肠末端改良自闭式造口术与回肠末端袢式造口术疗效及安全性均较好,但前者可明显缩短术后住院时间,减轻经济压力。

改良腹腔镜手术治疗卵巢子宫内膜异位囊肿伴不孕症的临床效果

目的探讨改良腹腔镜手术治疗卵巢子宫内膜异位囊肿(OMA)伴不孕症的临床效果。方法选取2022年3月至2023年1月平原县第一人民医院收治的90例OMA伴不孕症患者作为研究对象,按照随机数字表法分为对照组(45例)和实验组(45例)。对照组应用传统腹腔镜手术,实验组应用改良腹腔镜手术,比较两组临床效果。结果两组手术时间、术中出血量和首次肛门排气时间比较,差异无统计学意义(P>0.05),实验组妊娠率高于对照组(P<0.05);实验组T淋巴细胞水平优于对照组(P<0.05);实验组术后促卵泡激素、黄体生成素、雌二醇低于对照组(P<0.05)。结论改良腹腔镜手术治疗OMA伴不孕症患者的临床效果较好,能够改善T淋巴细胞水平及卵巢功能,提高妊娠率。