单孔腹腔镜子宫肌瘤剥除术缝合口诀临床应用初探  

Primary clinical experience of the uterine suture formula for single-port laparoscopic myomectomy

作　　者：吴忆寒 汤慧敏 贾秋成 陈婉莹 陈梦月 杨雲 赵梦如 陈继明[1] WU Yihan;TANG Huimin;JIA Qiucheng;CHEN Wanying;CHEN Mengyue;YANG Yun;ZHAO Mengru;CHEN Jiming(Department of Gynecology,The Third Affiliated Hospital of Nanjing Medical University(Changzhou Second People's Hospital),Changzhou,Jiangsu 213000,China)

机构地区：[1]南京医科大学第三附属医院(常州市第二人民医院)妇科,江苏常州213000

出　　处：《手术电子杂志》2024年第4期28-32,共5页Electronic Journal of Medical Operations

基　　金：常州市卫健委科技项目重大项目(ZD202314);常州市“十四五”卫生健康高层次人才培养工程(2022CZBJ074);江苏省妇幼健康重点人才项目(RC202101);江苏省妇幼健康科研项目(F202138);江苏省博士后科研资助计划(2019K064);江苏省“333工程”科研资助项目(BRA2019161)

摘　　要：目的 初步探讨经脐单孔腹腔镜子宫肌瘤剥除术“缝合口诀”临床应用技巧的可行性与安全性。方法 回顾性分析2022年12月—2023年6月常州市第二人民医院妇科收治的16例进行单孔腹腔镜子宫肌瘤剥除术患者的临床资料,术中均采用缝合口诀进行操作,对临床资料进行总结分析。结果 16例患者的手术时间(55~110)min,平均(77.50±17.03)min;术中出血量(10~80)mL,平均(36.25±30.08)mL;血红蛋白下降值(1~7)g/L,平均(4.06±1.77)g/L;术后住院天数(4~6)d,平均(4.81±0.83)d;术后首次肛门排气时间(18~30)h,平均(23.81±4.10)h;术后12 h视觉模拟量表(VAS)评分1~3分,平均(1.44±0.63)分。手术均顺利完成,术中未出现邻近脏器损伤、大出血、皮下气肿等并发症,无增加操作孔或中转开腹等操作。有1例患者术后出现发热,予抗生素抗感染治疗后次日好转。16例患者术后恢复良好,均顺利出院,对手术时间、术后恢复时间、切口美容效果比较满意。结论 在具备一定单孔腹腔镜缝合技术基础的前提下,经脐单孔腹腔镜子宫肌瘤剥除术“缝合口诀”技巧运用于合适的病例可能是安全可行的。Objective To explore the feasibility and safety of the clinical application of the"suture formula"for transumbilical single-port laparoscopic myomectomy.Methods The clinical data of 16 patients,who were admitted to the Department of Gynecology of Changzhou No.2 People's Hospital and underwent single-port laparoscopic myomectomy from December 2022 to June 2023,were retrospectively analyzed.Suture formula was used for all operations.Finally,the clinical data of the patients were summarized and analyzed.Results The operation time of 16 patients ranged from 55 to 110 min,with a mean of(77.50±17.03)min.Intraoperative bleeding ranged from 10 to 80 mL,with a mean of(36.25±30.08)mL.The hemoglobin drop value ranged from 1 to 7 g/L,with a mean of(4.06±1.77)g/L.Postoperative hospitalization days ranged from 4 to 6 days,with a mean of(4.81±0.83)days.Time to first postoperative anal exhaust ranged from 18 to 30 h,with a mean of(23.81±4.10)h.Postoperative VAS scores ranged from 1-3 points at 12 h,with a mean of(1.44±0.63)points.All surgeries were successfully completed without intraoperative complications such as injury to neighboring organs,hemorrhage or subcutaneous emphysema,and there were no operations such as additional operating holes or intraoperative conversion to open abdomen.One patient developed postoperative fever,which improved the next day after antibiotic anti-inflammatory treatment.All 16 patients had good postoperative recovery and were successfully discharged from the hospital.And they were relatively satisfied with the operation time,postoperative recovery time,and cosmetic effect of the incision.Conclusion With some basic technique of single-port laparoscopic suturing,the"suture formula"technique of transumbilical single-port laparoscopic myomectomy may be safe and feasible to apply in appropriate cases.

关 键 词：单孔腹腔镜手术 子宫肌瘤 缝合口诀 缝合技巧 

分 类 号：R73[医药卫生—肿瘤]