[1]朱其舟 舒宽勇 龙生根 肖仲清**.常规器械单孔腹腔镜辅助阴式子宫切除术[J].中国微创外科杂志,2020,01(2):104-110.
 Zhu Qizhou,Shu Kuanyong,Long Shenggen,et al.Clinical Study of Singleport Laparoscopicassisted Vaginal Hysterectomy With Conventional Instruments[J].Chinese Journal of Minimally Invasive Surgery,2020,01(2):104-110.
点击复制

常规器械单孔腹腔镜辅助阴式子宫切除术()
分享到:

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年2期
页码:
104-110
栏目:
临床研究
出版日期:
2020-02-28

文章信息/Info

Title:
Clinical Study of Singleport Laparoscopicassisted Vaginal Hysterectomy With Conventional Instruments
作者:
朱其舟 舒宽勇 龙生根 肖仲清**
(江西省妇幼保健院肿瘤科,南昌330006)
Author(s):
Zhu Qizhou Shu Kuanyong Long Shenggen et al.
Department of Gynecological Oncology, Maternal and Child Health Hospital of Jiangxi Province, Nanchang 330006, China
关键词:
单孔腹腔镜全子宫切除术
Keywords:
Singleport laparoscopyTotal hysterectomy
文献标志码:
A
摘要:
目的探讨单孔腹腔镜辅助阴式全子宫切除术(laparoscopicassisted vaginal hysterectomy,LAVH)的应用价值。方法对2016年10月~2018年10月因非恶性妇科疾病行LAVH进行回顾性分析。依照患者意愿分为单孔和三孔组各30例。单孔组使用一次性单孔套管穿刺系统。比较2组手术指标和并发症。结果2组均无中转开腹手术,无肠管、输尿管、膀胱或大血管损伤。单孔组术后血红蛋白降低少[(17.1±6.5)vs.(20.9±8.1)g/L,P=0.045];2组手术时间[(73.1±243)vs.(70.3±22.1)min,P=0.639],子宫重量[(311.2±185.3)vs.(339.4±234.3)g,P=0.607],排气时间[(34.1±5.8)vs.(34.2±4.7)h,P=0.961],总住院时间[(4.1±1.1)vs.(4.3±1.0)d,P=0.541],术后并发症发生率(3例vs. 3例,P=1000)差异无显著性。2组术后短暂性麻痹性肠梗阻3例(单孔组2例,三孔组1例),盆腔血肿2例(2组各1例),败血症1例(三孔组),未出现与穿刺器相关的并发症(如脐疝)。结论单孔LAVH显示术中出血较少及几乎无瘢痕的优势,与三孔手术结局及并发症相似。
Abstract:
ObjectiveTo explore the application value of singleport laparoscopicassisted vaginal hysterectomy (LAVH).MethodsA retrospective clinical study was performed in patients undergoing hysterectomy for nonmalignant gynecological diseases from October 2016 to October 2018. According to the patient’s wishes, they were divided into either singleport group or threeport group, with 30 cases in each. Disposable singleport trocar puncture system was applied in the singleport group. Surgical outcomes and complications were compared between the two groups statistically.ResultsThere was no conversion to open surgery in both groups, and there were no intestinal, ureteral, bladder or large blood vessel injuries. It showed lower postoperative hemoglobin reduction in the singleport group than the threeport group [(17.1±6.5) vs. (20.9±8.1) g/L, P=0.045]. There were no significant differences between the two groups in operation time [(73.1±24.3) vs. (70.3±22.1) min, P=0.639], uterine weight [(311.2±185.3) vs. (339.4±234.3) g, P=0.607], intestinal ventilation time [(34.1±5.8) vs. (34.2±4.7) h, P=0961], total hospital stay [(4.1±1.1) vs. (4.3±1.0) d, P=0.541], and the incidence of postoperative complications (3 vs. 3 cases, P=1.000). There were 3 cases of transient paralytic ileus in both groups (2 cases in the singleport group and 1 in the threeport group), 2 cases of pelvic hematoma (1 in each group), and 1 case of sepsis (in threeport group). There were no puncturerelated complications such as umbilical hernias.ConclusionSingleport LAVH shows advantages of less intraoperative bleeding and almost no scarring, with outcomes and complications similar to the threeport surgery.

参考文献/References:

[1]Zhang J,Sun D,Lang J.Feasibility and early outcomes of singleport access total laparoscopic hysterectomy among Chinese patients.Int J Gynaecol Obstet,2015,131(2):206-207.
[2]Greco F,Veneziano D,Wagner S,et al.Laparoendoscopic singlesite radical nephrectomy for renal cancer: technique and surgical outcomes.Eur Urol,2012,62(1):168-174.
[3]Yoon BS,Seong SJ,Kim IH,et al.Operative outcomes of singleportaccess laparoscopyassisted vaginal hysterectomy compared with singleportaccess total laparoscopic hysterectomy.Taiwan J Obstet Gynecol,2014,53(4):486-489.
[4]Chen YJ,Wang PH,Ocampo EJ,et al.Singleport compared with conventional laparoscopicassisted vaginal hysterectomy:a randomized controlled trial.Obstet Gynecol,2011,117(4):906-912.
[5]Koyanagi T,Motomura S.Transumbilical singleincision laparoscopic surgery:application to laparoscopically assisted vaginal hysterectomy.Arch Gynecol Obstet,2011,283(2):305-309.
[6]王延洲,梁志清.经自然腔道内镜手术在妇科恶性肿瘤中的应用.中国实用妇科与产科杂志,2019,35(12):1318-1320.
[7]Moulton L,Jernigan AM,Carr C,et al.Singleport laparoscopy in gynecologic oncology:seven years of experience at a single institution.Am J Obstet Gynecol,2017,217(5):610.e1-610.e8.
[8]Kim JH,Lee YH,Chong GO,et al.Total vaginal and singleport total laparoscopic hysterectomy for uterine benign diseases.Minim Invasive Ther Allied Technol,2016,25(3):148-153.
[9]Martynov I,Lacher M.Homemade glove port for singleincision pediatric endosurgery (SIPES) appendectomy:how we do it.European J Pediatr Surg Rep,2018,6(1):e56-e58.
[10]Pontis A,Sedda F,Mereu L,et al.Review and metaanalysis of prospective randomized controlled trials (RCTs) comparing laparoendoscopic single site and multiport laparoscopy in gynecologic operative procedures.Arch Gynecol Obstet,2016,294(3):567-577.
[11]Boruta DM.Laparoendoscopic singlesite surgery in gynecologic oncology:an update.Gynecol Oncol,2016,141(3):616-623.
[12]姜海军,宫轲.单孔腹腔镜手术进展与未来.中国微创外科杂志,2010,10(1):37-40.

备注/Memo

备注/Memo:
基金项目:江西省科技厅社会发展科技支撑项目(20122BBG70117)**通讯作者,Email:xiaozhongqing369@163.com
更新日期/Last Update: 2020-05-16