探讨腹壁缝合钳辅助单孔腹腔镜卵巢囊肿剥除术的疗效。

回顾性分析2018年1月至2019年2月于青岛大学附属青岛妇女儿童医院行微创卵巢囊肿剥除术145例患者的临床资料，其中50例行腹壁缝合钳辅助单孔腹腔镜卵巢囊肿剥除术(腹壁缝合钳辅助单孔组)、45例行单孔腹腔镜卵巢囊肿剥除术(单孔组)、50例行多孔腹腔镜卵巢囊肿剥除术(多孔组)。比较3组的一般资料、术中指标、术后指标及围手术期并发症。

腹壁缝合钳辅助单孔组、单孔组、多孔组患者的手术时间分别为(53.3±6.5)min 、(70.8±6.6)min、(52.3±6.2)min，腹壁缝合钳辅助单孔组的手术时间短于单孔组，差异有统计学意义(P<0.001)；腹壁缝合钳辅助单孔组与多孔组比较，差异无统计学意义(P>0.05)。腹壁缝合钳辅助单孔组、单孔组、多孔组患者的住院费用分别为(11 850.7±142.2)元、(12 934.6±138.9)元、(11 883.1±131.9)元，腹壁缝合钳辅助单孔组的住院费用低于单孔组，差异有统计学意义(P<0.001)；腹壁缝合钳辅助单孔组与多孔组比较，差异无统计学意义(P>0.05)。腹壁缝合钳辅助单孔组、单孔组、多孔组患者的术后24 h疼痛视觉模拟评分(visual analogue scale, VAS)分别为(2.0±0.8)分、(1.9±0.7)分、(2.5±0.8)分，腹壁缝合钳辅助单孔组的术后24 h VAS低于多孔组，差异有统计学意义(P<0.001)；腹壁缝合钳辅助单孔组与单孔组比较，差异无统计学意义(P>0.05)。腹壁缝合钳辅助单孔组、单孔组、多孔组患者的术后1个月切口美容评分(cosmetic score, CS)分别为(21.1±0.9)分、(21.1±0.9)分、(17.5±0.6)分，腹壁缝合钳辅助单孔组的术后1个月CS高于多孔组，差异有统计学意义(P<0.001)；腹壁缝合钳辅助单孔组与单孔组比较，差异无统计学意义(P>0.999)。3组患者的术中出血量、术后肛门排气时间、术后住院时间、术后1个月术后体象量表评分及围手术期并发症发生率比较，差异无统计学意义。

腹壁缝合钳辅助单孔腹腔镜卵巢囊肿剥除术是安全、可行的，与单孔腹腔镜卵巢囊肿剥除术比较，具有手术时间缩短、住院费用降低的优势；与多孔腹腔镜卵巢囊肿剥除术比较，具有减轻疼痛、美观的优势；可作为一种符合经济效益的手术方式在基层医院推广应用。

To explore the effect of abdominal wall suture forcep assisted LESS in ovarian cystectomy.

Retrospectively collected the clinical data of 145 patients who underwent minimally invasive ovarian cystectomy at Qingdao Women and Children′s Hospital Affiliated to Qingdao University from Jan. 2018 to Feb. 2019.50 of them underwent abdominal wall suture forcep assisted LESS in ovarian cystectomy(the abdominal wall suture forcep assisted LESS group), 45 of them underwent LESS in ovarian cystectomy(the LESS group), and 50 of them underwent muiti-port laparoscopic surgery in ovarian cystectomy(the multi-port group). The general data, intraoperative indicators, postoperative indicators and perioperative complication were compared in the three groups.

The operation time of the three groups was [(53.3±6.5)min vs (70.8±6.6)min vs (52.3±6.2) min]. The operation time of the abdominal wall suture forcep assisted LESS group was shorter than the LESS group and the difference was statistically significant (P<0.001) .The difference between the abdominal wall suture foecep assisted LESS group and the multi-port group was no statistically significant(P>0.05). The hospital cost of the three groups was [(11 850.7±142.2)RMB vs (12 934.6±138.9)RMB vs (11 883.1±131.9)RMB]. The hospital cost of the abdominal wall suture forcep assisted LESS group was lower than the LESS group and the difference was statistically significant (P<0.001). The difference between the abdominal wall suture forcep assisted LESS group and the multi-port group was no statistically significant (P>0.05). The VAS at 24 hour after surgery of the three groups was [(2.0±0.8) vs (1.9±0.7) vs (2.5±0.8)]. The VAS at 24 hour after surgery of the abdominal wall suture forcep assisted LESS group was lower than the multi-port group and the difference was statistically significant (P<0.001). The difference between the abdominal wall suture forcep assisted LESS group and the LESS group was no statistically significant(P>0.05). The CS at 1 month after surgery of the three groups was [(21.1±0.9) vs (21.1±0.9) vs (17.5±0.6)]. The CS at 1 month after surgery of the abdominal wall suture forcep assisted LESS group was higher than the multi-port group and the difference was statistically significant (P<0.001). The difference between the abdominal wall suture forcep assisted LESS group and the LESS group was no statistically significant (P>0.999). The difference of the intraoperative blood loss, the postoperative anal exhaust time, the postoperative hospital stay, the BIS at 1 month after surgery and the rate of perioperative complication in the three groups was no statistically significant.

The abdominal wall suture forcep assisted LESS in ovarian cystectomy is safe and feasible. Compared with the LESS in ovarian cystectomy, it has the advantages of shorter operation time and lower hospital cost. Compared with the muiti-port laparoscopic surgery in ovarian cystectomy, it has the advantages of relieving pain and aesthetics. It can be promoted as an economical surgery method in basic hospitals.