不同入路单孔腹腔镜输卵管及附件切除术的临床对比研究  

Clinical comparative study of single-port laparoscopic salpingectomy and adnexectomy via different approaches

作　　者：张桂萍 陈超 孙静莉 ZHANG Gui-ping;CHEN Chao;SUN Jing-li(Department of Obstetrics and Gynecology,General Hospital of Northern Theater Command of Chinese People's Liberation Army,Shenyang Liaoning 110006,China)

机构地区：[1]中国人民解放军北部战区总医院妇产科,辽宁沈阳110006

出　　处：《局解手术学杂志》2024年第8期680-684,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：辽宁省民生科技计划(2021JH2/10300096)。

摘　　要：目的对比不同入路单孔腹腔镜单侧输卵管切除术及附件(卵巢+输卵管)切除术的疗效,探讨单孔单手无入路平台腹腔镜的安全性及可行性。方法选取2021年8月至2022年11月于我院拟行单侧输卵管切除术的患者94例、单侧附件切除术的患者78例,分别随机分为单孔单手无入路平台组、单孔双手无入路平台组、单孔使用入路平台组。观察比较3组患者手术时间、术中出血量、术后病率、术后肛门排气时间、术后住院时间、总住院费用、切口长度、术后疼痛视觉模拟量表(VAS)评分、手术并发症、术后体象量表(BIS)评分及美容评分(CS)。结果3组患者的手术时间、术中出血量、术后病率、术后肛门排气时间、术后住院时间、手术并发症比较,差异均无统计学意义(P>0.05)。3组患者总住院费用、切口长度、术后VAS评分、术后BIS评分、术后CS比较,差异均有统计学意义(P<0.05)。结论单孔单手无入路平台腹腔镜输卵管切除术及附件切除术是一种安全、可行的手术方式,较单孔使用入路平台及单孔双手无入路平台腹腔镜手术具有切口小、住院费用少、切口满意度更高的优势。Objective To compare the efficacy of single-port laparoscopic unilateral salpingectomy and adnexectomy(ovary+fallopian tube)via different approaches,and to explore the safety and feasibility of single-port single-handed laparoscopy without access platform.Methods A total of 94 patients who underwent unilateral salpingectomy and 78 patients who underwent unilateral adnexectomy in our hospital from August 2021 to November 2022 were selected and randomly divided into the single-port single-handed without access platform group,the single-port double-handed without access platform group,and the single-port with access platform group,respectively.The operation time,intraoperative blood loss,postoperative morbidity,postoperative anal exhaust time,postoperative hospitalization time,total hospitalization cost,incision length,postoperative pain visual analogue scale(VAS)score,surgical complications,postoperative body image scale(BIS),and cosmetic score(CS)of patients in the three groups were observed and compared.Results There was no statistically significant difference in operative time,intraoperative blood loss,postoperative morbidity,postoperative anal exhaust time,postoperative hospitalization time,and surgical complications among the three groups(P>0.05).There were statistically significant differences in total hospitalization cost,incision length,postoperative VAS score,postoperative BIS score,and postoperative CS among the three groups(P<0.05).Conclusion Single-port single-handed laparoscopy salpingectomy and adnexectomy without access platform is a safe and feasible surgical method,which has the advantages of smaller incision,less hospitalization cost,and higher incision satisfaction than single-port surgery with access platform and single-port double-handed laparoscopic surgery without access platform.

关 键 词：单孔腹腔镜 单孔单手无入路平台腹腔镜 输卵管切除术 附件切除术 

分 类 号：R713.51[医药卫生—妇产科学] R713.6[医药卫生—临床医学]