改良经脐单孔腹腔镜子宫肌瘤剔除术  

Improved Transumbilical Single-port Laparoscopic Surgery for Myomectomy

作　　者：王晓樱[1] 李妍[1] Wang Xiaoying;Li Yan(Department of Obstetrics and Gynecology,Shengjing Hospital,China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院妇产科

出　　处：《中国微创外科杂志》2019年第10期919-921,共3页Chinese Journal of Minimally Invasive Surgery

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。Objective To explore the safety and feasibility of improved transumbilical single-port laparoscopic surgery in hysteromyomectomy.Methods We 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.Results Compared 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).Conclusion Improved 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.

关 键 词：经脐单孔腹腔镜手术 腹腔镜手术 子宫肌瘤 

分 类 号：R73[医药卫生—肿瘤]