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中华腔镜外科杂志(电子版) ›› 2018, Vol. 11 ›› Issue (04) : 248 -252. doi: 10.3877/cma.j.issn.1674-6899.2018.04.016

所属专题: 文献

综述

单孔腹腔镜在子宫内膜异位症中的应用及研究进展
任远1, 刘海元1,()   
  1. 1. 100730 北京,中国医学科学院 北京协和医学院 北京协和医院妇产科
  • 收稿日期:2018-06-11 出版日期:2018-08-30
  • 通信作者: 刘海元
  • 基金资助:
    国家自然科学基金面上项目(81471441)

Laparoendoscopic single-site surgery in endometriosis: current practice and future perspective

Yuan Ren1, Haiyuan Liu1,()   

  1. 1. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
  • Received:2018-06-11 Published:2018-08-30
  • Corresponding author: Haiyuan Liu
  • About author:
    Corresponding author: Liu Haiyuan, Email:
引用本文:

任远, 刘海元. 单孔腹腔镜在子宫内膜异位症中的应用及研究进展[J/OL]. 中华腔镜外科杂志(电子版), 2018, 11(04): 248-252.

Yuan Ren, Haiyuan Liu. Laparoendoscopic single-site surgery in endometriosis: current practice and future perspective[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(04): 248-252.

腹腔镜手术因其微创的优势,现已成为多种妇科良性、恶性疾病的主要手术方式,但是血管与内脏损伤、切口疝、感染、疼痛等问题在腹腔镜手术中依然存在,单孔腹腔镜通过减少穿刺通道的数量,可以在一定程度上减少这些并发症的发生,并具有更为明显的美容优势。目前单孔腹腔镜领域研究的前沿问题之一是其在子宫内膜异位症特别是卵巢子宫内膜异位囊肿中的应用。若干研究已经证实了单孔腹腔镜在子宫内膜异位症手术治疗中的安全性及可行性,但其是否会进一步损伤卵巢储备,目前仍存在争议。文献表明,在卵巢囊肿剔除术中尽量减少能量器械的使用或能在一定程度上保护卵巢储备。本文将对这些研究做一简单综述。

Laparoscopic surgery has been widely adopted in varieties of benign and malignant gynecologic conditions as it is associated with decreased perioperative complications, enhanced postoperative recovery, shortened hospitalization days and improved incision cosmetic effect. Yet risks of morbidity associated with multiple incisions, including vascular and visceral injury, hernia and infection, pain and other issues still exist. Laparoendoscopic single-site surgery (LESS) may minimize the risks described above and enchance the cosmetic benefits of conventional laparoscopy by performing all the procedures through a small channel in the umbilicus. The safety and feasibility of introducing LESS into endometriosis, especially for treating of ovarian endometrioma, has been confirmed by several studies, while its impact on ovarian reserve still remains controversial, this paper will make a brief summary of these studies.

1
Sajid MS, Ladwa N, Kalra L, et al. Single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: meta-analysis and systematic review of randomized controlled trials[J]. World J Surg, 2012,36(11):2644-2653.
2
Fan X, Lin T, Xu K, et al. Laparoendoscopic single-site nephrectomy compared with conventional laparoscopic nephrectomy: a systematic review and meta-analysis of comparative studies[J]. Eur Urol, 2012,62(4):601-612.
3
Gill RS, Shi X, Al-Adra DP, et al. Single-incision appendectomy is comparable to conventional laparoscopic appendectomy: a systematic review and pooled analysis[J]. Surg Laparosc Endosc Percutan Tech, 2012,22(4):319-327.
4
Yang TX, Chua TC. Single-incision laparoscopic colectomy versus conventional multiport laparoscopic colectomy: a meta-analysis of comparative studies[J]. Int J Colorectal Dis, 2013,28(1):89-101.
5
Song T, Cho J, Kim TJ, et al. Cosmetic outcomes of laparoendoscopic single-site hysterectomy compared with multi-port surgery: randomized controlled trial[J]. J Minim Invasive Gynecol, 2013,20(4):460-467.
6
Hoyer-Sørensen C, Vistad I, Ballard K. Is single-port laparoscopy for benign adnexal disease less painful than conventional laparoscopy? a single-center randomized controlled trial[J]. Fertil Steril, 2012,98(4):973-979.
7
Wheeless CR Jr, Thompson BH. Laparoscopic sterilization. Review of 3600 cases[J]. Obstet Gynecol, 1973,42(5):751-758.
8
Pelosi MA. Laparoscopic supracervical hysterectomy using a single-umbilical puncture (mini-laparoscopy)[J]. Journal of Reproductive Medicine, 1992, 37(9):777-784.
9
Kosumi T, Kubota A, Usui N, et al. Laparoscopic ovarian cystectomy using a single umbilical puncture method[J]. Surg Laparosc Endosc Percutan Tech, 2001,11(1):63-65.
10
Ghezzi F, Cromi A, Fasola M, et al. One-trocar salpingectomy for the treatment of tubal pregnancy: a 'marionette-like' technique[J]. BJOG, 2005,112(10):1417-1419.
11
Langebrekke A, Qvigstad E.Total laparoscopic hysterectomy with single-port access without vaginal surgery[J]. J Minim Invasive Gynecol, 2009,16(5):609-611.
12
Fader AN1, Escobar PF. Laparoendoscopic single-site surgery (LESS) in gynecologic oncology: technique and initial report[J]. Gynecol Oncol, 2009,114(2):157-161.
13
Song T, Kim ML, Jung YW, et al. Laparoendoscopic single-site versus conventional laparoscopic gynecologic surgery: a metaanalysis of randomized controlled trials[J]. Am J Obstet Gynecol, 2013,209(4):317-319.
14
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.
15
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.
16
Giudice LC. Clinical practice: endometriosis[J]. New England Journal of Medicine, 2010, 362(25):2389-2398.
17
Beretta P, Franchi M, Ghezzi F, et al. Randomized clinical trial of two laparoscopic treatments of endometriomas: cystectomy versus drainage and coagulation[J]. Fertil Steril, 1998,70(6):1176-1180.
18
Park JY, Kim DY, Kim SH, et al. Laparoendoscopic single-site compared with conventional laparoscopic ovarian cystectomy for ovarian endometrioma[J]. J Minim Invasive Gynecol, 2015,22(5):813-839.
19
Bedaiwy MA, Farghaly T, Hurd W, et al. Laparoendoscopic single-site surgery for management of ovarian endometriomas[J]. Jsls Journal of the Society of Laparoendoscopic Surgeons, 2014, 18(2):191-196.
20
Kitajima M, Khan KN, Hiraki K, et al. Changes in serum anti-mullerian hormone levels may predict damage to residual normal ovarian tissue after laparoscopic surgery for women with ovarian endometrioma[J]. Fertil Steril, 2011,95(8):2589-2591.
21
Goodman LR, Goldberg JM, Flyckt RL, et al. Effect of surgery on ovarian reserve in women with endometriomas, endometriosis and controls[J]. Am J Obstet Gynecol, 2016,215(5):589-589.
22
Song T, Lee SH, Kim WY. Additional benefit of hemostatic sealant in preservation of ovarian reserve during laparoscopic ovarian cystectomy: a multi-center, randomized controlled trial[J]. Human Reproduction, 2014, 29(8):1659-1665.
23
Deckers P, Ribeiro SC, Simões RDS, et al. Systematic review and meta-analysis of the effect of bipolar electrocoagulation during laparoscopic ovarian endometrioma stripping on ovarian reserve[J]. Int J Gynaecol Obstet, 2018,140(1):11-17.
24
Raffi F, Metwally M, Amer S. The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis[J]. J Clin Endocrinol Metab, 2012,97(9):3146-3154.
25
Yoon BS, Kim YS, Seong SJ, et al. Impact on ovarian reserve after laparoscopic ovarian cystectomy with reduced port number: a randomized controlled trial[J]. Eur J Obstet Gynecol Reprod Biol, 2014,176(1):34-38.
26
Angioni S, Pontis A, Cela V, et al. Surgical technique of endometrioma excision impacts on the ovarian reserve. single-port access laparoscopy versus multiport access laparoscopy: a case control study[J]. Gynecological Endocrinology, 2015, 31(6):454-457.
27
Song T, Kim WY, Lee KW, et al. Effect on ovarian reserve of hemostasis by bipolar coagulation versus suture during laparoendoscopic single-site cystectomy for ovarian endometriomas[J]. J Minim Invasive Gynecol, 2015,22(3):415-420.
28
Kim TJ, Shin SJ, Kim TH, et al. Multi-institution, prospective, randomized trial to compare the success rates of single-port versus multiport laparoscopic hysterectomy for the treatment of uterine myoma or adenomyosis[J]. J Minim Invasive Gynecol, 2015,22(5):785-791.
29
Boruta DM. Laparoendoscopic single-site surgery in gynecologic oncology: an update[J]. Gynecol Oncol, 2016,141(3):616-623.
30
Lopez S, Mulla ZD, Hernandez L, et al. A comparison of outcomes between robotic-assisted, single-site laparoscopy versus laparoendoscopic single site for benign hysterectomy[J]. J Minim Invasive Gynecol, 2016,23(1):84-88.
31
Guan X, Nguyen MT, Walsh TM, et al.Robotic single-site endometriosis resection using firefly technology[J]. J Minim Invasive Gynecol, 2016,23(1):10-11.
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