[1]韩晖① 张静 孔庆铎 魏宏祎 王永军**.经脐单孔腹腔镜与传统腹腔镜卵巢囊肿剥除术的比较[J].中国微创外科杂志,2020,01(2):107-110.
 Han Hui,Zhang Jing*,Kong Qingduo*,et al.Comparison Between Transumbilical Singlesite Laparoscopy and Traditional Laparoscopy for Ovarian Cystectomy[J].Chinese Journal of Minimally Invasive Surgery,2020,01(2):107-110.
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经脐单孔腹腔镜与传统腹腔镜卵巢囊肿剥除术的比较()
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《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:
107-110
栏目:
临床研究
出版日期:
2020-02-28

文章信息/Info

Title:
Comparison Between Transumbilical Singlesite Laparoscopy and Traditional Laparoscopy for Ovarian Cystectomy
作者:
韩晖① 张静 孔庆铎 魏宏祎 王永军**
(北京大学国际医院妇科,北京102206)
Author(s):
Han Hui Zhang Jing* Kong Qingduo* et al.
*Department of Gynecology, Peking University International Hospital, Beijing 102206, China
关键词:
单孔腹腔镜传统腹腔镜卵巢囊肿
Keywords:
Singlesite laparoscopyTraditional laparoscopyOvarian cyst
文献标志码:
A
摘要:
目的探讨经脐单孔腹腔镜卵巢囊肿剥除术的安全性和临床价值。方法对2017年3月~2019年8月我院87例良性卵巢囊肿剥除术进行回顾性分析,其中单孔腹腔镜卵巢囊肿剥除术43例(单孔腹腔镜组),传统腹腔镜卵巢囊肿剥除术44例(传统腹腔镜组),比较2组手术时间、术中囊肿破裂率、术后血红蛋白(hemoglobin,Hb)下降幅度、术后24 h疼痛视觉模拟评分(Visual Analogue Scale,VAS)、排气时间、住院时间。结果2组患者均无中转开腹和手术并发症发生。单孔腹腔镜组囊肿破裂率81.3%,明显高于传统腹腔镜组56.8%(χ2=6.137,P=0.013),术后24 h疼痛VAS评分单孔腹腔镜组明显低于传统腹腔镜组[1(0~2)分 vs. 2(0~3)分,Z=-3.575,P=0.000],排气时间明显早于传统腹腔镜组[(26.5±111)h vs.(33.1±11.8)h,t=-2.654,P=0.009]。2组手术时间、术后Hb下降幅度和住院时间差异均无统计学意义(P>0.05)。 结论经脐单孔腹腔镜良性卵巢囊肿剥除术是安全和可行的,但囊肿破裂率明显增高,应重视术前良恶性肿瘤的评估,交界性或恶性肿瘤慎用此术式。
Abstract:
ObjectiveTo explore the safety and clinical value of transumbilical singlesite laparoscopic ovarian cystectomy.MethodsData of 87 patients receiving ovarian cystectomy from March 2017 to August 2019, including singlesite laparoscopy group (n=43) and traditional laparoscopy group (n=44), were retrospectively collected. The outcomes of both groups were analyzed and compared, including duration of operation, rate of rupture of cyst during operation, decrease of hemoglobin (Hb), postoperative Visual Analogue Scale (VAS), exhaust time and hospital stay.ResultsThere was no conversion to laparotomy or surgical complications in both groups, and no conversion to conventional laparoscopy in the singlesite laparoscopic group. The rupture rate of cyst in the singlesite laparoscopy group was significantly higher than that in the traditional laparoscopy group (81.3% vs. 56.8%, χ2=6.137, P=0013). The postoperative VAS lower in the singlesite laparoscopy group than the traditional laparoscopic group [1 (0-2) points vs. 2 (0-3) points, Z=-3.575, P=0.000], and the exhaust time was earlier than that of traditional laparoscopic group [(26.5±11.1) h vs. (33.1±11.8) h, t=-2.654, P=0.009]. There was no significant difference in operation time, decrease of Hb, and hospitalization time (P>0.05).ConclusionsTransumbilical singlesite laparoscopic ovarian cystectomy is safe and feasible, but the rate of rupture of the cyst is obviously increased. We should pay attention to evaluate whether the tumor is benign or malignant before the operation. The operation should be used cautiously for borderline and malignant tumors.

参考文献/References:

[1]Sun HD, Horng HC, Liu CH, et al. Comparison of singleport and threeport laparoscopic salpingectomy in the management for tubal pregnancy. J Chin Med Assoc,2018,81(5):469-474.
[2]刘秀,温蒙科,刘海元,等.单孔腹腔镜与多孔腹腔镜卵巢囊肿剔除术的临床对照研究.中华妇产科杂志,2017,52(10):675-678.
[3]Kim YW, Park BJ, Ro DY, et al. Singleport laparoscopic myomectomy using a new singleport transumbilical morcellation system: initial clinical study. J Minim Invasive Gynecol,2010,17(5):587-592.
[4]Park JY, Kim DY, Kim SH, et al. Laparoendoscopic singlesite compared with conventional laparoscopic ovarian cystectomy for ovarian endometrioma. J Minim Invasive Gynecol,2015,22(5):813-819.
[5]Huang BS, Wang PH, Tsai HW, et al. Singleport compared with conventional laparoscopic cystectomy for ovarian dermoid cysts. Taiwan J Obstet Gynecol,2014,53(4):523-529.
[6]Sangnier E, Lallemant M, Gnofam M, et al. Single port laparoscopy (SPL): Retrospective study evaluating postoperative pain in comparison with conventional laparoscopy (CL). J Gynecol Obstet Hum Reprod,2018,47(8):365-369.
[7]Monnet E. Laparoscopic entry techniques: What is the controversy? Vet Surg,2019,48(S1):S6-S14.
[8]邓娟,曹云桂,雷慧,等.经脐单孔腹腔镜手术治疗巨大卵巢囊肿.中国微创外科杂志,2019,19(8):699-701.
[9]高志红,全丽丽,万翠英,等.腹腔镜术后穿刺孔腹膜种植子宫肌瘤1例.实用妇产科杂志,2014,30(4):302-303.
[10]Pelosi MA, Pelosi MR. Laparoscopic hysterectomy with bilateral salpingooophorectomy using a single umbilical puncture. N J Med, 1991,88(10):721-726.
[11]Cho BR, Han JW, Kim TH, et al. Single port access laparoscopic surgery for large adnexal tumors: Initial 51 cases of a single institute. Obstet Gynecol Sci,2017,60(1):32-38.
[12]王晓樱,李妍.改良经脐单孔腹腔镜子宫肌瘤剔除术.中国微创外科杂志,2019,19(10):919-921.
[13]Jeong JH, Kim YR, Hong KP, et al. Clinical experience with singleport access laparoscopic cystectomy and myomectomy. Clin Exp Reprod Med,2016,43(1):44-50.

备注/Memo

备注/Memo:
基金项目:北京大学国际医院院内科研基金(YN2018ZD03)**通讯作者,Email:wyongjunhys@sina.com①(河北省宁晋县妇幼保健院妇产一科,宁晋055550)
更新日期/Last Update: 2020-05-16