“筷子技术”单孔和多孔腹腔镜应用于子宫内膜癌的对比研究  

Comparison between transumbilical laparoendoscopic single-site surgery with"chopstick technique"and conventional multi-port laparoscopic surgery for endometrial cancer

作　　者：邓媛 姚远洋 余美佳 王瑞伟 梁小龙 王延洲 Deng Yuan;Yao Yuanyang;Yu Meijia;Wang Ruiwei;Liang Xiaolong;Wang Yanzhou(Department of Obstetrics and Gynecology,the First Affiliated Hospital of the Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院妇产科,重庆400038

出　　处：《中华医学杂志》2025年第8期617-620,共4页National Medical Journal of China

摘　　要：比较接受经脐单孔腹腔镜手术(TU-LESS)与多孔腹腔镜手术(MLS)子宫内膜癌(EC)患者围手术期结果,并评估"筷子技术"TU-LESS的安全性、可行性和有效性。回顾性纳入2018年8月至2021年8月接受手术治疗的EC患者535例,将接受"筷子技术"TU-LESS治疗的患者划分为TU-LESS组,接受MLS治疗的患者划分为MLS组。经1∶2倾向得分匹配后得到TU-LESS组患者39例,MLS组76例。纳入患者年龄为(50.8±7.8)岁,TU-LESS组和MLS组年龄、体质指数、生育史、腹盆腔手术史、国际妇产科联盟(FIGO)2014版分期及组织学分级差异均无统计学意义(均P>0.05)。TU-LESS组比MLS组手术时间更长[(175.2±57.1)比(152.9±56.4)min,P=0.048]、术后视觉模拟评分更低[1(1,2)比2(2,3)分,P<0.001]、术后切口满意度评分更高[(5.7±0.5)比(5.2±0.7)分,P=0.001]。两组患者术中出血量、盆腔及腹主动脉旁淋巴结切除数目、围手术期并发症发生率、术后住院时间差异均无统计学意义(均P>0.05)。相较于传统腹腔镜技术,"筷子技术"TU-LESS具有术后疼痛轻、患者对切口的满意度高等优点,疗效与MLS相当。To compare perioperative outcomes between transumbilical laparoendoscopic single-site surgery(TU-LESS)and conventional multi-port laparoscopic surgery(MLS)in patients with endometrial cancer(EC),and evaluate the safety,feasibility,and efficacy of the"Chopstick Technique"TU-LESS.The single-center retrospective study included 535 patients who underwent surgical treatment between August 2018 and August 2021.Patients treated with the"Chopstick Technique"TU-LESS were assigned to the TU-LESS group,and those treated with MLS were assigned to the MLS group.After propensity score matching,39 patients in the TU-LESS group and 76 patients in the MLS group were included.The age of the included patients was(50.8±7.8)years,and there were no significant differences between the TU-LESS and MLS groups in terms of age,body mass index,obstetric history,history of abdominal and pelvic surgery,International Federation of Gynecology and Obstetrics(FIGO)2014 staging,or histological grade(all P>0.05).The TU-LESS group had a longer operative time compared to the MLS group[(175.2±57.1)vs(152.9±56.4)min,P=0.048],but had lower postoperative visual analog scale pain scores[1(1,2)vs 2(2,3)scores,P<0.001]and higher postoperative incision satisfaction scores[(5.7±0.5)vs(5.2±0.7)scores,P=0.001].There were no significant differences between the two groups in terms of intraoperative blood loss,number of pelvic and paraaortic lymph nodes removed,incidence of perioperative complications,or length of postoperative hospital stay(all P>0.05).Compared to traditional laparoscopic techniques,the"chopstick technique"TU-LESS had advantages,such as less postoperative pain and higher patient satisfaction with the incision,with a similar efficacy to MLS.

关 键 词：癌 子宫内膜样 “筷子技术”单孔腹腔镜 多孔腹腔镜 全面分期手术 

分 类 号：R737.33[医药卫生—肿瘤]