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中华腔镜外科杂志(电子版) ›› 2018, Vol. 11 ›› Issue (01) : 35 -38. doi: 10.3877/cma.j.issn.1674-6899.2018.01.010

所属专题: 文献

论著

悬吊线法经脐单孔腹腔镜在妇科手术的应用
王春阳1, 韩璐1,(), 郭凤2   
  1. 1. 116033 大连医科大学附属大连市妇产医院暨大连市妇幼保健院妇科
    2. 116033 大连医科大学附属大连市妇产医院暨大连市妇幼保健院病案信息管理科
  • 收稿日期:2017-12-31 出版日期:2018-02-28
  • 通信作者: 韩璐

Clinical application of transumbilical suture-suspension single port laparoscopic in gynecological surgerye

Chunyang Wang1, Lu Han1,(), Feng Guo2   

  1. 1. Department of Gynecology, Dalian Obstetrics and Gynecology Hospital, Affiliated to Dalian Medical University, Dalian 116033, China
    2. Department of Medical Records Information Management, Dalian Obstetrics and Gynecology Hospital, Affiliated to Dalian Medical University, Dalian 116033, China
  • Received:2017-12-31 Published:2018-02-28
  • Corresponding author: Lu Han
  • About author:
    Corresponding author: Han Lu, Email:
引用本文:

王春阳, 韩璐, 郭凤. 悬吊线法经脐单孔腹腔镜在妇科手术的应用[J/OL]. 中华腔镜外科杂志(电子版), 2018, 11(01): 35-38.

Chunyang Wang, Lu Han, Feng Guo. Clinical application of transumbilical suture-suspension single port laparoscopic in gynecological surgerye[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(01): 35-38.

目的

探讨"悬吊线法"经脐单孔腹腔镜在妇科手术应用的可行性。

方法

收集2017年1-12月大连医科大学附属大连市妇产医院收治的135例卵巢囊肿、子宫肌瘤患者的临床资料,观察组采用"悬吊线法"行单孔腹腔镜手术,其中卵巢囊肿剔除术30例,子宫肌瘤剔除术15例;对照组行多孔腹腔镜手术,其中卵巢囊肿剔除术60例,子宫肌瘤剔除术30例。观察两组的手术时间、术中出血量、术后血红蛋白下降幅度、术后24 h发热的最高体温、术后住院时间、术后并发症、术后24 h视觉模拟评分法(visual analogue scale/score, VAS)评分、体象量表(body image scale, BIS)评分、切口美观满意度CS评分等指标。

结果

135例均成功完成手术。比较观察组与对照组的术中出血量[(48.44 ± 7.97)ml vs(40.07 ± 8.62)ml]、术后血红蛋白下降幅度[(13.27±6.05)g/L vs(12.44±5.91)g/L]、术后24 h发热的最高体温[(37.32 ± 0.23)℃ vs(37.29 ± 0.18)℃]、术后住院时间[(4.22 ± 1.66)d vs(4.44±1.22)d],差异均无统计学意义(P> 0.05);比较观察组与对照组的手术时间[(77.44 ± 28.10)min vs(54.00 ± 27.89)min]、术后24h VAS评分[(5.33±0.74)分vs(5.56 ± 1.31)分]、BIS评分[(5.13 ± 0.41)分vs (5.44 ± 0.91)分]、切口美观满意度CS评分[(41.23 ± 1.04)分vs(39.29±2.02)分],差异有统计学意义(P< 0.05)。

结论

经脐单孔腹腔镜手术在妇科良性疾病中应用是可行的,"悬吊线法"在一定程度上降低了单孔腹腔镜手术中的手术难度。

Objective

The feasibility of using suture-suspension in laparoendoscopic single-site surgery in gynecologic surgery.

Methods

Collected the clinical data of 135 patients, with ovarian cysts or uterine fibroids, who were admitted to Dalian Maternity Hospital affiliated to Dalian Medical University from Jan. to Dec.2017, Observation group had treated by suture-suspension single port laparoscopic surgery, Ovarian cyst excision in 30 cases, Myomectomy in 15 cases; The control group had treated by line porous laparoscopic surgery, Ovarian cyst excision in 60 cases, Myomectomy in 30 cases. operation time, intraoperative bleeding, postoperative hemoglobin(Hb) decline, the highest temperature after surgery in 24 h, postoperative hospitalization, postoperative complications, VAS score after surgery in 24 h, body image scale BIS score, cutting aesthetic satisfaction CS score etc clinical data were observed between the two groups.

Results

All the 135 cases were successfully operated. There is not statistical significance(P> 0.05) of comparing intraoperative blood loss[(48.44 ± 7.97)ml vs(40.07 ± 8.62)ml], postoperative Hb decline[(13.27 ± 6.05)g/L vs(12.44 ± 5.91)g/L], the highest temperature after surgery in 24 h[(37.32 ± 0.23)℃ vs (37.29 ± 0.18)℃], postoperative exhaust time[(4.22 ± 1.66)d vs(4.44 ± 1.22)d] of observation group and control group; There is statistical significance(P <0.05) of comparing the operation time[(77.44 ± 28.10)min vs(54.00 ± 27.89)min], VAS score after surgery in 24 h[(5.33 ± 0.74)vs(5.56 ± 1.31)], BIS score[(5.13 ± 0.41)vs(5.44 ± 0.91)], CS score[(41.23 ± 1.04)vs (39.29 ± 2.02)] of observation group and control group.

Conclusions

Transumbilical single port laparoscopic surgery in gynecological benign diseases surgery is feasible, suture-suspension to a certain extent, reduce the difficulty of laparoendoscopic single-site surgery.

表1 经脐单孔腹腔镜手术患者的两组一般临床资料比较(±s)
表2 经脐单孔腹腔镜手术患者的两组围手术期相关指标比较(±s)
表3 经脐单孔腹腔镜手术患者的两组术后疼痛、切口美观满意度比较(分,±s)
[1]
Angioni S, Pontis A, Sedda F, et al. Single-port versus conventional multiport access prophylactic laparoscopic bilateral salpingo- oophorectomy in high-risk patients for ovarian cancer: a comparison of surgical outcomes[J]. On co Targets Ther, 2015, 8(2): 1575-1580.
[2]
Yanishi M, Kinoshita H, Mishima T, et al. Influence of scars on body image consciousness with respect to gender following laparoendoscopic single-site versus conventional laparoscopic surgery[J]. Scand J Urol, 2017, 51(1): 57-61.
[3]
刘秀,刘海元,史宏晖,等. 妇科单孔腹腔镜卵巢囊肿剔除术对卵巢功能的影响[J/CD]. 中华腔镜外科杂志(电子版), 2016, 9(6):375-377.
[4]
王丹莹,刘海元,史宏晖,等. 不同腹壁通道在单孔腹腔镜卵巢囊肿剔除术中的应用[J]. 生殖医学杂志,2017, 26(7):689-693.
[5]
赵万成,杨清,王光伟. 经脐单切口腹腔镜在子宫肌瘤剔除术中的应用[J]. 中国内镜杂志,2014, 20(3):286-289.
[6]
Rd BF, Vassaur H, Monsivais S, et al. Single-incision laparoscopic appendectomy versus traditional three-port laparoscopic appendectomy: an analysis of outcomes at a single institution[J]. Surgical Endoscopy, 2014, 28(2): 626-630.
[7]
Pontarelli EM, Emami C, Nguyen NX, et al. Single-incision laparoscopic resection of ovarian masses in children: a preliminary report[J]. Pediatric Surgery International, 2013, 29(7): 715-718.
[8]
Abu-Rafea B, Vilos GA, Al-Obeed O, et al. Monopolar electrosurgery through single-port laparoscopy: a potential hidden hazard for bowel burns[J]. J Minim Invasive Gynecol, 2011, 18(6): 734-740.
[9]
刘泽良,朱建方,何伟. 腹腔镜胆囊切除术中胆囊缝线悬吊技术的应用体会(附1200例报告)[J]. 腹腔镜外科杂志,2015,20(8):602-605.
[10]
戴小明,黄秋林,贺更生,等. 改良腹壁吊线经脐单孔腹腔镜胆囊切除术[J]. 中国内镜杂志,2012, 18(4):384-386.
[11]
孙大为,张俊吉,熊巍,等. 单孔腹腔镜下子宫内膜癌分期手术的临床报告[J/CD]. 中华腔镜外科杂志(电子版), 2014,7(1):10-13.
[12]
王延洲,陈功立,徐嘉莉,等. 单孔腹腔镜广泛子宫切除盆腔淋巴结清扫治疗宫颈癌:一项单中心的初步研究[J]. 第三军医大学学报,2017, 39(13):1392-1395.
[13]
Boruta DM, Fagotti A, Bradford LS, et al. Laparoendoscopic single-site radical hysterectomy with pelvic lymphadenectomy: initial multi-institutional experience for treatment of invasive cervical cancer[J]. Journal of Minimally Invasive Gynecology, 2014, 21(3): 394-398.
[14]
Park JY, Kim DY, Suh DS. et al. Thoracic endoscopic single-site versus conventional.laparoscopic surgical staging for early-stage endometrial cancer [J] .IntJGynecol Cancer, 2014, 24(2): 358-363.
[15]
中华医学会妇产科学分会妇科单孔腹腔镜手术技术协助组. 妇科单孔腹腔镜手术技术的专家意见[J]. 中华妇产科杂志,2016, 51(10):724-726.
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