经脐单孔腹腔镜在卵巢输卵管巨大囊肿剥除术中的临床优势  

Clinical advantages of transumbilical single-site laparoscopy in surgery for giant ovariotubal cysts

作　　者：焦海宁[1] 刘延[1] 钟慧萍[1] 冯炜炜 朱岚[1] Jiao Haining;Liu Yan;Zhong Huiping;Feng Weiwei;Zhu Lan(Department of Gynecology and Obstetrics,Ruijin Hospital of Shanghai Jiaotong University,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院妇产科,上海200025

出　　处：《中国医师杂志》2022年第3期406-410,共5页Journal of Chinese Physician

摘　　要：目的探讨经脐单孔腹腔镜手术治疗卵巢输卵管巨大囊肿的可行性和安全性。方法回顾性分析2018年1月至2019年6月上海交通大学医学院附属瑞金医院收治的38例卵巢输卵管巨大囊肿患者,分为单孔腹腔镜组(18例)和传统腹腔镜组(20例),比较两组患者手术时间、术中出血量、镇痛例数等围手术期相关指标。结果38例患者均顺利完成手术,无中转开腹,单孔腹腔镜组无增加辅助孔;术后均未发生并发症,无囊液外漏。单孔腹腔镜组18例患者脐孔部位瘢痕隐藏满意。单孔腹腔镜组和传统腹腔镜组手术时间[(51.67±13.72)min vs(55.50±14.59)min]、术中出血量[(52.22±24.38)ml vs(61.50±28.88)ml]、术后首次肛门排气时间[(25.77±8.59)h vs(27.60±6.67)h]差异均无统计学意义(均P>0.05);单孔腹腔镜组需术后镇痛例数(2例vs 12例)少于传统腹腔镜手术组(P<0.05);下床活动时间[(20.95±3.65)h vs(26.95±5.43)h]及术后出院时间[(3.11±0.68)h vs(4.30±1.21)h]短于传统腹腔镜手术组(均P<0.05)。38例患者术后均门诊随访6~24个月,切口愈合好,无一例复发。结论术前排除恶性卵巢输卵管肿瘤可能,经脐单孔腹腔镜手术治疗巨大卵巢输卵管囊肿是可靠安全的。Objective To observe the efficacy and safety of single-port laparoscopy for giant ovariotubal cysts.Methods 38 patients with giant ovarian and fallopian tube cysts in Ruijin Hospital Affiliated to Shanghai Jiaotong University Hospital from January 2018 to June 2019 were retrospectively analyzed.They were divided into transumbilical single-port laparoscopy group(18 cases)and traditional laparoscopy group(20 cases).The perioperative related indexes such as operation time,intraoperative bleeding and the number of analgesic cases were compared between the two groups.Results All 38 patients successfully completed the operation without conversion to laparotomy,and no auxiliary hole was added in the single-port laparoscopy group;There were no postoperative complications and no cystic fluid leakage.In the single-port laparoscopy group,18 patients were satisfied with the concealment of umbilical scar.There was no statistically significant difference in operation time[(51.67±13.72)min vs(55.50±14.59)min],intraoperative blood loss[(52.22±24.38)ml vs(61.50±28.88)ml]and first postoperative anal exhaust time[(25.77±8.59)h vs(27.60±6.67)h]between single-port laparoscopy group and traditional laparoscopy group(all P>0.05);The number of cases requiring postoperative analgesia in the single-port laparoscopy group(2 cases vs 12 cases)was less than that in the traditional laparoscopy group(P<0.05);The out of bed activity time[(20.95±3.65)h vs(26.95±5.43)h]and postoperative discharge time[(3.11±0.68)h vs(4.30±1.21)h]were shorter than those in the traditional laparoscopy group(all P<0.05).All 38 patients were followed up in the gynecological clinic for 6-24 months.The incision healed well without recurrence.Conclusions Transumbilical single-port laparoscopic surgery for giant ovarian and fallopian tube cysts is reliable and safe when the possibility of malignant ovarian and fallopian tube tumors was excluded before operation.

关 键 词：脐 腹腔镜检查 卵巢囊肿 输卵管囊肿 

分 类 号：R713.6[医药卫生—妇产科学]