[1]赵晓蕾 段丽君*.经脐单孔腹腔镜保护卵巢功能的卵巢囊肿剥除术[J].中国微创外科杂志,2024,01(2):102-105.
　Zhao Xiaolei,Duan Lijun..Transumbilical Singleport Laparoscopic Ovarian Cyst Excision With Protection of Ovarian Function[J].Chinese Journal of Minimally Invasive Surgery,2024,01(2):102-105.
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经脐单孔腹腔镜保护卵巢功能的卵巢囊肿剥除术()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2024年2期
页码:
102-105
栏目:
临床研究
出版日期:
2024-02-25

文章信息/Info

Title:
Transumbilical Singleport Laparoscopic Ovarian Cyst Excision With Protection of Ovarian Function
作者:
赵晓蕾 段丽君*
(武汉市江夏区第一人民医院妇科，武汉430030)
Author(s):
Zhao Xiaolei;  Duan Lijun.
Department of Gynecology, First People’s Hospital of Jiangxia District, Wuhan 430030, China
关键词:
卵巢囊肿剥除术; 经脐单孔腹腔镜; 卵巢功能
Keywords:
Ovarian cyst excision; Transumbilical singleport laparoscopy; Ovarian function
文献标志码:
A
摘要:
目的探讨经脐单孔腹腔镜保护卵巢功能的卵巢囊肿剥除术的经验。方法2018年7月~2019年12月我院行56例单孔腹腔镜卵巢囊肿剥除术，术中横行切开脐部约2 cm，置入单孔套管穿刺器，建立人工气腹。超声刀避开卵巢门在其对侧切开卵巢皮质以保证良好血供，固定患侧卵巢，便于钝性分离囊肿并尽可能保留卵巢正常组织，选择20可吸收缝线缝合止血以及卵巢成形。结果56例均顺利完成卵巢囊肿剥除术，其中3例双侧卵巢囊肿剥除术，3例联合输卵管切除，1例联合输卵管系膜囊肿剥除术，2例联合子宫肌瘤剔除术，1例联合阑尾切除术(因术后需腹腔引流，增加1个穿刺孔)，1例联合宫腔镜子宫内膜息肉电切术，1例联合盆腔粘连松解术。手术时间(72.0±30.0)min。术后住院时间（5.0±0.6） d。无一例发生并发症。56例随访2~3年，平均1.5年，无并发症发生，无切口愈合不良，卵巢囊肿无复发。术后6、12个月与术前比较卵巢窦卵泡数差异无显著性［(7.02±1.57)个vs.(7.05±1.55)个，P=1.000;(6.93±1.46)个vs.(7.05±1.55）个，P=1000］。术后3个月与术前比较卵巢基质血流差异无显著性（P>0.05），提示卵巢功能无减退。结论保护卵巢功能的关键是术中合理选择手术器械与切口、精细化操作剥离卵巢囊肿以及保护卵巢的血供。
Abstract:
ObjectiveTo investigate the clinical application value of transumbilical singleport laparoscopic ovarian cyst excision with protection of ovarian function.MethodsFrom July 2018 to December 2019, we performed 56 cases of singleport laparoscopic ovarian cyst debulking, in which the umbilicus was incised transversely for about 2 cm and a singleport trocar puncture was placed to form an artificial pneumoperitoneum. The ultrasonic knife was used to avoid the ovarian hilum and cut the ovarian cortex on the opposite side of the ovary to ensure a good blood supply. The ovary on the affected side was fixed to facilitate blunt separation of the cyst and preserve the normal tissues of the ovary as much as possible. The 20 absorbable suture was applied for hemostasis and ovarian reconstruction.ResultsThe operations were successfully completed in all the 56 cases, including bilateral ovarian cyst excision in 3 cases, salpingectomy in 3 cases, tubal mesangial cyst excision in 1 case, hysteromyomectomy in 2 cases, appendectomy in 1 case (an additional puncture hole was added due to the need for abdominal drainage after the operation), hysteroscopic resection of endometrial polyps in 1 case, and pelvic adhesion release in 1 case. The operation time was (72.0±30.0) min, and the postoperative hospitalization time was (5.0±0.6) d. No complication occurred. The 56 patients were followed up for 2-3 years, with an average of 1.5 years, with no complications, poor wound healing, or recurrence of ovarian cysts. There was no significant difference in the number of ovarian antral follicles between 6 and 12 months after surgery and before surgery ［7.02±1.57 vs. 7.05±155, P=1.000; 6.93±1.46 vs. 7.05±1.55, P=1.000］. There was no significant difference in ovarian stromal blood flow (P>0.05), indicating no decrease in ovarian function.ConclusionThe key to protecting ovarian function is the rational selection of surgical instruments and incisions, precise performance of resection of ovarian cysts, and protection of ovarian blood supply.

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备注/Memo

备注/Memo:
*通讯作者，Email：2642128466@qq.com
更新日期/Last Update: 2024-05-03