单一部位切口腹腔镜手术在巨大卵巢肿瘤中的应用  

Laparoendoscopic Single-site Surgery in the Treatment of Giant Ovarian Tumors

作　　者：张坤[1] 王一婷[1] 姚颖[1] 杨俊芳[1] 韩劲松[1] Zhang Kun;Wang Yiting;Yao Ying(Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China)

机构地区：[1]北京大学第三医院妇产科,北京100191

出　　处：《中国微创外科杂志》2020年第5期421-423,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：国家重点研发计划“生殖健康及重大出生缺陷防控研究”重点专项(2016YFC1000900,2016YFC1000904)。

摘　　要：目的探讨单一部位切口腹腔镜手术(laparoendoscopic single-site surgery,LESS)在巨大卵巢肿瘤(直径>10 cm)中的应用价值。方法对2017年4月~2018年12月在我院因巨大卵巢囊肿行卵巢囊肿剔除或患侧附件切除的46例资料进行回顾性分析,其中LESS 23例,肿瘤直径(16.32±5.06)cm,传统三孔腹腔镜手术23例,肿瘤直径(14.08±2.78)cm,2组差异无显著性(t=1.861,P=0.069)。比较2组手术时间、术中出血量、手术并发症、术后24 h疼痛视觉模拟评分(Visual Analogue Scale,VAS)、住院时间、术后满意度。结果LESS组行卵巢囊肿剔除18例,患侧附件切除2例,卵巢肿瘤分期手术(大网膜部分切除+盆腔及腹主动脉旁淋巴结活检)3例;三孔组分别为16例、6例、1例。2组手术过程顺利,均无术中及术后并发症。LESS组无囊肿破裂,三孔组囊肿破裂5例(21.7%),差异有显著性(P=0.049),2组术式、手术时间、术中出血量、术后住院时间差异无显著性(P>0.05),但术后切口疼痛VAS评分LESS组[(4.17±1.24)分]高于三孔组[(3.47±0.94分)](t=2.157,P=0.036)。术后6个月2组满意度差异无显著性(P>0.05)。结论对于巨大卵巢肿瘤,LESS手术难度低,探查全面,安全可行,患者满意度高,具有一定的应用价值。Objective To investigate the value of laparoendoscopic single-site surgery(LESS)in the treatment of giant ovarian tumors(>10 cm).Methods A total of 46 patients with giant ovarian cyst who underwent cystectomy or salpingo-oophorectomy from April 2017 to December 2018 in our hospital were studied retrospectively.Among them,there were 23 cases of LESS(LESS group),with the tumor diameter of(16.32±5.06)cm,and 23 cases of traditional three-port laparoscopic surgery(three-port group),with the tumor diameter of(14.08±2.78)cm.There was no significant difference between the two groups(t=1.861,P=0.069).The operation time,intraoperative blood loss,surgical complication,24-hour postoperative pain Visual Analogue Scale(VAS)score,length of hospital stay,and postoperative satisfaction were compared between the two groups.Results In the LESS group,18 patients had ovarian cyst removal,2 patients had adnexectomy,and 3 patients had ovarian tumor staging surgery.In the three-port group,16 patients had ovarian cyst removal,6 patients had adnexectomy,and 1 patient had ovarian tumor staging surgery.All the surgeries were completed successfully without any complications.There was no rapture of cyst in the LESS group and 5 cases(21.7%)in the three-port group,with significant difference(P=0.049).There was no significant difference in surgery type,operative time,intraoperative bleeding and postoperative hospital stay between the two groups(P>0.05).But the postoperative VAS pain score of the LESS group[(4.17±1.24)points]was higher than that of the three-port group[(3.47±0.94)points,t=2.157,P=0.036].There was no significant difference in the 6-month postoperative satisfaction between the two groups(P>0.05).Conclusions To treat large ovarian tumors,LESS is safe and feasible,and easy to perform.It provides comprehensive exploration and offers high satisfaction,which has certain application value.

关 键 词：单一部位切口腹腔镜手术 巨大 卵巢肿瘤 

分 类 号：R73[医药卫生—肿瘤]