单孔腹腔镜在妇科良性肿瘤手术中的应用优势——附163例临床分析  

Advantages of Laparoendoscopic Single Site Surgery in Benign Gynecolog-ic Surgery:Clinical Analysis of 163 Cases

作　　者：史洵玮 石宇 张国楠 王登凤 Shi Xunwei;Shi Yu;Zhang Guonan;Wang Dengfeng(Gynecologic Oncology Center,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)

机构地区：[1]四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学医学院妇科肿瘤中心,成都610041

出　　处：《肿瘤预防与治疗》2021年第4期348-352,共5页Journal of Cancer Control And Treatment

基　　金：四川省医学重点学科建设项目(川卫办发[2007]407号)。

摘　　要：目的:探讨单孔腹腔镜(laparoendoscopic single site surgery,LESS)对比多孔腹腔镜(multiport laparoscopic surgery,MLS)在妇科良性肿瘤手术中的优势。方法:收集2018年1月1日至2019年12月31日在我院妇科肿瘤中心行腹腔镜手术治疗的妇科良性肿瘤患者,比较接受不同手术入路的患者在术后恢复情况和并发症发生率等方面的差异。结果:共纳入317例患者,其中LESS组163例、MLS组154例。两组在住院时间、术后发热发生率、肠道功能恢复时间方面差异无统计学意义(P>0.05);LESS组较MLS组的手术时间更长、术中出血量更多,但术后疼痛评分更低、术后住院时间更短(P<0.05)。结论:LESS手术具有更微创、更美观、术后疼痛更轻、术后恢复更快的优势,应用于妇科良性肿瘤具备一定优势。但LESS较MLS的手术操作难度更大,需要经过严格的系统训练和一个相对更长的学习周期,LESS专用器械的使用可以一定程度降低难度。Objective: To compare the advantages of laparoendoscopic single-site surgery(LESS) with multiport laparoscopic surgery(MLS) for benign gynecological tumors. Methods: Clinical data of patients with benign gynecological tumors treated by laparoscopic surgery from January 2018 to December 2019 were retrospectively analyzed. Differences in postoperative recovery and complications between patients by different surgical approaches were compared. Results: Data of 317 patients, including 163 patients treated by LESS(the LESS group) and 154 patients by MLS(the MLS group), were collected. There were no significant differences in total length of stay, postoperative fever and intestinal function recovery time between two groups(P>0.05). The LESS group was inferior to the MLS group in operation duration and intraoperative blood loss, but superior to the latter in postoperative length of stay and pain(P<0.05). Conclusion: LESS is a safer and more reliable strategy for benign gynecologic tumors for minimally invasive cosmetic procedures, less postoperative pain and faster postoperative recovery. However, the operation of LESS is more difficult than that of MLS, which requires strict, systematic and long-term training. The use of special instruments can reduce the difficulty of LESS to a certain extent.

关 键 词：单孔腹腔镜 妇科 良性肿瘤 手术治疗 

分 类 号：R737.3[医药卫生—肿瘤] R730.56[医药卫生—临床医学]