经自然腔道腹腔镜与经脐单孔腹腔镜治疗肥胖患者卵巢囊肿的效果对比  

Clinical comparison of natural orifice transluminal endoscopic surgery and transumbilical laparoendoscopic single site surgery in the treatment of ovarian cyst among patients with obesity

作　　者：王莹东 徐玲玲[1] 滕悦[1] 吴悦 李大可 Wang Yingdong;Xu Lingling;Teng Yue;Wu Yue;Li Dake(Department of Gynecological Oncology,Women′s Hospital of Nanjing Medical University,Nanjing 210004,China)

机构地区：[1]南京医科大学附属妇产医院妇科肿瘤科,南京210004

出　　处：《中国临床保健杂志》2021年第2期272-274,共3页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨经自然腔道腹腔镜手术(vNOTES)和经脐单孔腹腔镜手术(TU-LESS)对肥胖且有卵巢囊肿患者的临床应用效果。方法回顾分析行vNOTES的15例肥胖患者与同期行TU-LESS的30例肥胖患者的临床资料,对比两组疗效。结果所有入组患者均顺利完成手术、无严重术中并发症发生、手术全程未更改术式且顺利出院。vNOTES组手术时间、住院时间与TU-LESS组相比均稍短,但差异无统计学意义(P>0.05)。vNOTES组术中出血量、留置尿管时间、术后进食时间、肛门排气时间、下床活动时间分别为26(17,74)mL、(6.3±2.6)h、(6.7±2.9)h、(7.3±2.6)h、(7.6±2.3)h,TU-LESS组为60(28,86)mL、(9.7±2.4)h、(11.3±3.4)h、(12.9±3.9)h、(9.8±3.1)h,两组差异有统计学意义(P<0.05)。vNOTES组术后切口感染率更低,盆腔感染发生率较TU-LESS更高,但均差异无统计学意义(P>0.05)。结论对肥胖患者而言,vNOTES与TU-LESS治疗卵巢囊肿在手术时间与住院时间上结果相近,但vNOTES在术中出血量、术后恢复速度方面优于TU-LESS,有利于改善生活质量。Objective To study the clinical application effect of natural orifice transluminal endoscopic surgery(NOTES)and transumbilical laparoendoscopic single site surgery(TU-LESS)in obese patients.Methods The clinical data of 15 obese patients who underwent transvaginal natural orifice transluminal endoscopic surgery(vNOTES)and 30 obese patients who underwent TU-LESS were retrospectively analyzed,and the curative effects of the two groups were compared.Results All patients in the group completed the operation successfully,no serious intraoperative complications occurred,the operation method was not changed throughout the operation,and the operation was discharged smoothly.Compared with the TU-LESS group,the operation time and hospital stay in the vNOTES group were slightly shorter,but there was no significant difference(P>0.05).The intraoperative blood loss,indwelling catheter time,postoperative feeding time,anal exhaust time,and time to get out of bed in the vNOTES group were 26(17,74)mL,(6.3±2.6)h,(6.7±2.9)h,(7.3±2.6)h,(7.6±2.3)h,TU-LESS group were 60(28,86)mL,(9.7±2.4)h,(11.3±3.4)h,(12.9±3.9)h,(9.8±3.1)h,the difference between the two groups was significant(P<0.05).The incidence of postoperative incision infection in the vNOTES group was lower,and the incidence of pelvic infection was higher than that of TU-LESS,but there was no significant difference(P>0.05).Conclusion For obese patients,vNOTES and TU-LESS have similar effects in terms of operating time and hospital stay,and both need to pay attention to postoperative infection.However,the vNOTES is better than the TU-LESS in terms of intraoperative blood loss and postoperative recovery speed,which is beneficial to improve the quality of life.

关 键 词：卵巢肿瘤 肥胖症 腹腔镜检查 治疗结果 生活质量 

分 类 号：R47[医药卫生—护理学]