[1]王晓樱 李妍*.改良经脐单孔腹腔镜子宫肌瘤剔除术[J].中国微创外科杂志,2019,01(10):919-921.
　Wang Xiaoying,Li Yan..Improved Transumbilical Single-port Laparoscopic Surgery for Myomectomy[J].Chinese Journal of Minimally Invasive Surgery,2019,01(10):919-921.
点击复制

改良经脐单孔腹腔镜子宫肌瘤剔除术()
分享到：

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

卷:
01
期数:
2019年10期
页码:
919-921
栏目:
临床研究
出版日期:
2019-10-25

文章信息/Info

Title:
Improved Transumbilical Single-port Laparoscopic Surgery for Myomectomy
作者:
王晓樱 李妍*
（中国医科大学附属盛京医院妇产科，沈阳110004）
Author(s):
Wang Xiaoying;  Li Yan.
Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, Shenyang 110004, China
关键词:
经脐单孔腹腔镜手术; 腹腔镜手术; 子宫肌瘤
Keywords:
Transumblical single-port laparoendoscopic surgery; Laparoscopic surgery; Myoma of uterus
文献标志码:
A
摘要:
目的探讨改良经脐单孔腹腔镜子宫肌瘤剔除术的安全性及有效性。方法回顾性分析2017年7月~2018年12月腹腔镜子宫肌瘤剔除术113例资料，其中改良经脐单孔腹腔镜组60例（脐部2~2.5 cm切口置入自制入路平台和2个trocar，左下腹置入5 mm trocar和弯分离钳），常规三孔腹腔镜组53例。比较2组手术时间、术中出血量、术后引流量、术后排气时间、离床活动时间、术后住院时间、住院费用及术后即刻和24 h疼痛视觉模拟评分(Visual Analogue Scale，VAS)等指标。结果与三孔组相比，改良经脐单孔组手术时间短［(72.0±26.0)min vs. (92.5±27.5)min，t=-4.007，P=0.000］，术中出血少［(36.2±21.9)ml vs. (69.6±35.6)ml，t=-6.092，P=0.000］，术后24 h引流少［(92.0±60.7)ml vs. (115.3±53.4)ml，t=-2.152，P=0.034］，2组术后排气时间、离床活动时间、术后住院时间、住院费用、术后疼痛评分差异无统计学意义(P>0.05)。结论改良经脐单孔腹腔镜行子宫肌瘤剔除术不使用肌瘤粉碎器，同时克服单孔腹腔镜操作局限性，手术安全有效。
Abstract:
ObjectiveTo explore the safety and feasibility of improved transumbilical single-port laparoscopic surgery in hysteromyomectomy.MethodsWe retrospectively analyzed 113 patients with laparoscopic myomectomy hospitalized in our hospital from July 2017 to December 2018. There were 60 cases of improved transumbilical single-port laparoscopic surgery (a self-made access platform and two trocars were implanted through 2-2.5 cm umbilical incision, and a 5-mm trocar and bending forceps were implanted into the left lower abdomen) and 53 cases of 3-port laparoscopic surgery. The indicators of both groups, including operation time, intraoperative bleeding, postoperative drainage, postoperative exhaust time, first time to leave the bed, postoperative hospitalization, cost of hospitalization and postoperative pain Visual Analogue Scale (VAS) score were compared.ResultsCompared with the 3-port group, the operation time of the improved transumbilical single-port group was shorter ［(72.0±26.0) min vs. (92.5±27.5) min, t=-4.007, P=0.000］, the intraoperative bleeding was less ［(36.2±21.9) ml vs. (69.6±35.6) ml, t=-6.092, P=0.000］, and the amount of postoperative drainage was less ［(92.0±60.7) ml vs. (115.3±53.4) ml, t=-2.152, P=0.034］. No significant differences were observed in postoperative exhaust time, first time to leave the bed, postoperative hospitalization, cost of hospitalization and postoperative pain score (P>0.05).ConclusionImproved transumbilical single-port laparoscopic surgery in myomectomy eliminates the problems associated with the use of fibroid morcellators while overcoming the limitations of single-port laparoscopic procedures, being safe and feasible.

参考文献/References:

[1]冷金花,张震宇,段华,等.子宫肌瘤诊治的热点问题.现代妇产科进展,2007，16(5):321-333.
[2]Huang PS,Chang WC,Huang SC.Iatrogenic parasitic myoma:a case report and review of the literature.Taiwan J Obstet Gynecol,2014,53(3):392-396.
[3]Cucinella G，Granese R，Calagna G，et al.Parasitic myomas after laparoscopic surgery: an emerging complication in the use of morcellator?Description of four cases.Fertil Steril，2011，96(2):90-96.
[4]Milad MP,Milad EA.Laparoscopic morcellator-related complications. J Minim Invasive Gynecol,2014,21(3):486-491.
[5]Al-Talib A,Tulandi T.Pathophysiology and possible iatrogenic cause of leiomyomatosis peritonealis disseminata.Gynecol Obstet Invest,2010,69(4):239-244.
[6]王丹丹，杨青.腹腔镜手术中子宫肌瘤粉碎器应用相关临床问题的认识.中国实用妇科与产科杂志,2016，32（7）：616-620.
[7]Brlmann H,Tanos V,Grimbizis G,et al.Options on fibroid morcellation:a literature review.Gynecol Surg,2015,12(1):3-15.
[8]王丹丹，杨清.腹腔镜子宫肌瘤剔除术的相关问题及其处理.中国实用妇科与产科杂志,2015，31（5）：399-402.
[9]沈立翡,朱岚,瞿鹭,等.腹腔镜辅助腹壁小切口子宫肌瘤剔除术的临床应用研究.中国微创外科杂志,2010,10(3):220-222.
[10]朱兰,俞梅.子宫肌瘤手术治疗的进展.实用妇产科杂志,2007，23(12):712-714.
[11]Saccardi C,Gizzo S,Noventa M,et al.Limits and complications of laparoscopic myomectomy: which are the best predictors?A large cohort single-center experience. Arch Gynecol Obstet, 2014, 290(5):951-956.
[12]赵万成,杨清,王光伟.经脐单切口腹腔镜在子宫肌瘤剔除术中的应用.中国内镜杂志,2014,20(3):286-289.

备注/Memo

备注/Memo:
*通讯作者，E-mail：leeyan8888@163.com
更新日期/Last Update: 2020-01-09