[1]潘晓雨 张思佳 郭亮生** 任琼珍 陶晓敏 戴淑榕 唐怡璇 朱维培.疝针辅助脐周两孔腹腔镜与经脐单孔腹腔镜附件切除术的对比研究[J].中国微创外科杂志,2021,01(6):500-504.
　Pan Xiaoyu,Zhang Sijia,Guo Liangsheng,et al.Comparative Study on Hernia Needle Assisted Periumbilical Twoport Laparoscopy and Transumbilical Singleport Laparoscopy in Salpingooophorectomy[J].Chinese Journal of Minimally Invasive Surgery,2021,01(6):500-504.
点击复制

疝针辅助脐周两孔腹腔镜与经脐单孔腹腔镜附件切除术的对比研究()
分享到：

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

卷:
01
期数:
2021年6期
页码:
500-504
栏目:
临床研究
出版日期:
2021-06-25

文章信息/Info

Title:
Comparative Study on Hernia Needle Assisted Periumbilical Twoport Laparoscopy and Transumbilical Singleport Laparoscopy in Salpingooophorectomy
作者:
潘晓雨 张思佳 郭亮生** 任琼珍 陶晓敏 戴淑榕 唐怡璇 朱维培
（苏州大学附属第二医院妇产科，苏州215004）
Author(s):
Pan Xiaoyu;  Zhang Sijia;  Guo Liangsheng;  et al.
Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
关键词:
疝针; 腹腔镜手术; 单孔腹腔镜手术; 腹腔镜附件切除术
Keywords:
Hernia needle; Laparoscopic surgery; Singleport laparoscopic surgery; Laparoscopic salpingooophorectomy
文献标志码:
A
摘要:
目的探讨疝针辅助脐周两孔腹腔镜与经脐单孔腹腔镜在附件切除手术中的临床疗效。方法回顾性分析2016年1月~2019年10月我院120例附件良性病变行腹腔镜附件切除术的临床资料，按手术方式分为疝针两孔组（60例）与单孔组（60例），疝针两孔组行疝针辅助脐周两孔腹腔镜附件切除手术，单孔组行单孔腹腔镜附件切除手术，比较2组患者术中及术后一般情况、住院费用、术后24和48 h切口疼痛数字评分（Numeric Rating Scale,NRS)、Hollander切口愈合评分和切口并发症发生率。结果2组患者均顺利完成手术，术中无并发症发生。术后病理提示均为附件良性病变。疝针两孔组手术时间（42.2±17.6）min，明显短于单孔组（58.8±22.8）min（t=4.463，P=0.000）。2组术中出血量、术后住院时间差异无统计学意义（P>0.05）。疝针两孔组住院费用（11 701.0±56.1）元，明显少于单孔组（15 286.9±46.5）元（t=381.250，P=0000）。疝针两孔组术后24、48 h切口疼痛NRS评分、Hollander切口愈合评分均明显优于单孔组（t=13.048, P=0.000；t=8.870, P=0.000；t=-5.322，P=0.000）。疝针两孔组术后切口并发症发生率1.7%（1/60），明显低于单孔组21.7%（13/60）（χ2 =11.644，P=0001）。结论疝针辅助脐周两孔腹腔镜附件切除术安全可行，与单孔腹腔镜手术相比，缩短手术时间、减少术后疼痛及并发症，而且切口愈合情况更好，住院费用更低。
Abstract:
ObjectiveTo investigate the application value of hernia needle assisted periumbilical twoport laparoscopy and transumbilical singleport laparoscopy in salpingooophorectomy.MethodsClinical data of 120 female patients with benign adnexal lesions undergoing laparoscopic salpingooophorectomy from January 2016 to October 2019 in our hospital were retrospectively analyzed. The patients were divided into hernia needle twoport group (n=60) and singleport group (n=60). The hernia needle twoport group underwent hernia needle assisted periumbilical twoport laparoscopic salpingooophorectomy, while the singleport group underwent singleport laparoscopic salpingooophorectomy. The intraoperative and postoperative general conditions, hospitalization expenses, Numeric Rating Scales (NRS) of incision pain 24 and 48 h after operation, Hollander Wound Evaluation Scales, and incidence of incision complications were compared between the two groups.ResultsThe operations were completed successfully without complications during the operation in both groups of patients. Postoperative pathology showed benign adnexal lesions in all the patients. The operation time of the hernia needle twoport group (42.2±17.6) min was significantly less than that of the singleport group (588±22.8) min (t=4.463, P=0.000). There was no significant difference in blood loss and postoperative hospital stay between the two groups (P>005). The hospitalization expenses of the hernia needle twoport group (11 701.0±56.1) yuan was less than that of the singleport group (15 286.9±46.5) yuan (t=381.250, P=0.000). The 24 and 48 h postoperative NRS and Hollander Wound Evaluation Scales of the hernia needle twoport group were better than those of the singleport group (t=13.048, P=0.000; t=8.870, P=0.000; t=-5.322, P=0.000). The wound complication rate of the hernia needle twoport group was 1.7% (1/60), which was significantly lower than that in the singleport group ［21.7%(13/60), χ2=11.644, P=0.001］.ConclusionsCompared with singleport laparoscopic surgery, hernia needle assisted periumbilical twoport laparoscopic salpingooophorectomy is safe and feasible. It can not only shorten the operation time, reduce postoperative pain and complications, but also have better wound healing and lower hospitalization expenses.

参考文献/References:

[1]Rossetti D, Vitale SG, Gulino FA, et al. Laparoendoscopic singlesite surgery for the assessment of peritoneal carcinomatosis resectability in patients with advanced ovarian cancer. Eur J Gynaecol Oncol,2016,37(5):671-673.
[2]刘青,关小明.单孔腹腔镜在妇科中的应用现状及发展.实用妇产科杂志,2019,35(3):161-163．
[3]郑民华,张卓.腹腔镜经脐单孔腹腔镜和NOTES应用现状与评价.中国实用外科杂志,2009,29(1):33-34.
[4]鲍明月,秦真岳,陈继明,等.微切口单孔腹腔镜手术治疗妇科疾病30例分析.中国实用妇科与产科杂志,2020,36(9):872-873.
[5]郭亮生,张思佳,任琼珍,等.疝针辅助经脐两孔腹腔镜手术在输卵管切除术中的初步应用.中国微创外科杂志,2021,21(1):81-83.
[6]范秀华,耿艳红,范佳佳,等.经脐单孔腹腔镜与传统腹腔镜治疗妇科良性疾病的对比研究.中华腔镜外科杂志(电子版),2019,12(6):347-350.
[7]Boza A, Urman B, Vatansever D, et al. Minilaparoscopic gynecological surgery using smaller ports minimizes incisional pain and postoperative scar size: A paired sample analysis. Surg Innov,2020,27(5):455-460.
[8]周叶明,林融风,张孔亮,等.耻骨联合上横切口与脐部扩大切口在腹腔镜肝切除术标本取出中的对比研究.中华普通外科杂志,2020,35(1):73-74.
[9]李珺玮,陈义松,华克勤.单孔腹腔镜在妇科良性疾病中的应用.实用妇产科杂志,2019,35(3):170-172.
[10]龚瑶,周容,代雪林,等.自制入路通道单孔腹腔镜手术治疗妇科良性疾病60例临床分析.中国实用妇科与产科杂志,2019,35(3):330-333.
[11]中华医学会妇产科学分会妇科单孔腹腔镜手术技术协助组.妇科单孔腹腔镜手术技术的专家意见.中华妇产科杂志,2016,51(10):724-726.
[12]黄达元,孙莉,陈海晏,等.自制气体反压平台在经脐单孔腹腔镜妇科手术中的应用.中国微创外科杂志,2020,20(10):955-957.
[13]Fanfani F, Fagotti A, Gagliardi ML, et al. Minilaparoscopic versus singleport total hysterectomy: a randomized trial. J Minim Invasive Gynecol,2013,20(2):192-197.
[14]Laganà AS, Garzon S, D’Alterio MN, et al. Minilaparoscopy or singlesite robotic surgery in gynecology? Let’s think out of the box. J Invest Surg,2020:1-2.
[15]淡堰璇,张震宇.常规腹腔镜与迷你腹腔镜手术治疗子宫内膜异位症的比较.中国微创外科杂志,2018,18(4):313-315,322.

备注/Memo

备注/Memo:
基金项目：江苏省卫生健康委员会科研项目（QNRC2016881，F201922）；苏州市科技计划项目（SYSD2019106，SYS2020134）**通讯作者，Email:gls2135@sina.com
更新日期/Last Update: 2021-08-27