悬吊式免气腹单孔腹腔镜手术在妇科手术中的疗效分析
|
摘要
目的:探讨悬吊式免气腹单孔腹腔镜在妇科手术中的可行性。方法:回顾性分析我院2018年3月至2018年12月进行的悬吊式免气腹单孔腹腔镜手术45例患者的临床资料,其中异位妊娠手术7例,卵巢囊肿剥除术10例,附件切除术10例,子宫肌瘤剔除术8例,全子宫切除术10例,并分别选取同样病种常规腹腔镜手术患者作为对照,比较2组手术时间、术中出血量、术后疼痛情况、术后胃肠功能恢复时间、住院时间及相关并发症等。结果:2组均顺利完成手术,且术后均无相关并发症。对于异位妊娠患者,2组手术时间、术中出血量差异无统计学意义(P>0.05),而悬吊式免气腹单孔腹腔镜手术术后疼痛较轻,胃肠功能恢复较快,住院时间较短(P<0.05);对于卵巢囊肿剥除及附件切除患者,悬吊式免气腹单孔腹腔镜手术手术时间较短,术中出量较少,术后疼痛较轻,并且胃肠功能恢复较快,住院时间较短(P<0.05);对于子宫肌瘤剔除及全子宫切除患者,悬吊式免气腹单孔腹腔镜手术时间较常规腹腔镜手术时间长(P<0.05),但胃肠功能恢复较快,住院时间较短且悬吊式免气腹单孔腹腔镜子宫肌瘤剔除手术术后疼痛较轻(P<0.05),2组术中出血量差异无统计学意义(P>0.05)。结论:悬吊式免气腹单孔腹腔镜手术在妇科手术中具有一定的安全性以及可实施性,较常规的腹腔镜手术,具有更好的美容效果,以及术后疼痛轻、康复快等优点,值得临床推广应用。
Objective:To discuss the feasibility of suspension gasless single port laparoscopic surgery in gynecological surgery.Methods: The clinical data of 45 cases patients received suspension gasless laparoscopic surgery from Mar 2018 to Dec 2018 in our hospital were retrospective analyzed, including 7 cases of ectopic pregnancy, 10 cases of ovarian cyst excision, 10 cases of adnexectomy, 8 cases of hysteromyomectomy, 10 cases of total hysterectomy.The patients with same diseases received conventional laparoscopic surgery were selected as the control group. The operation time, intraoperative blood loss, postoperative pain, postoperative recovery of gastrointestinal function, hospitalization time and complications were compared.Results: The operation was completed successfully in both groups, and there were no postoperative complications. For patients with ectopic pregnancy, there was no significant difference in operative time and intraoperative blood loss between the two groups(P>0.05), but the postoperative pain was less,the recovery of gastrointestinal function was faster and the hospitalization time was less in suspension gasless single port laparoscopic surgery than those in conventional laparoscopic surgery(P<0.05). For patients with ovarian cyst excision and adnexectomy, the operative time was shorter, the intraoperative blood loss was less, the postoperative pain was less, the recovery of the gastrointestinal function was faster, and the hospitalization time was less in suspension gasless single port laparoscopic surgery than those in conventional laparoscopic surgery(P<0.05). For patients with hysteromyomectomy and total hysterectomy, the operative time was longer, but the recovery of gastrointestinal function was faster and hospitalization time was less than those in conventional laparoscopic surgery and the postopemtive pain was less in hgsteromyomectomy(P<0.05) and there was no significant difference in intraoperative blood loss between the two groups(P<0.05), Conclusions: Suspension gasless single port laparoscopic surgery in gynecological surgery is safe and feasible. Compared with conventional endoscopic surgery, it has better cosmetic effect, less pain and faster recovery, and is worthy of clinical application.
Objective:To discuss the feasibility of suspension gasless single port laparoscopic surgery in gynecological surgery.Methods: The clinical data of 45 cases patients received suspension gasless laparoscopic surgery from Mar 2018 to Dec 2018 in our hospital were retrospective analyzed, including 7 cases of ectopic pregnancy, 10 cases of ovarian cyst excision, 10 cases of adnexectomy, 8 cases of hysteromyomectomy, 10 cases of total hysterectomy.The patients with same diseases received conventional laparoscopic surgery were selected as the control group. The operation time, intraoperative blood loss, postoperative pain, postoperative recovery of gastrointestinal function, hospitalization time and complications were compared.Results: The operation was completed successfully in both groups, and there were no postoperative complications. For patients with ectopic pregnancy, there was no significant difference in operative time and intraoperative blood loss between the two groups(P>0.05), but the postoperative pain was less,the recovery of gastrointestinal function was faster and the hospitalization time was less in suspension gasless single port laparoscopic surgery than those in conventional laparoscopic surgery(P<0.05). For patients with ovarian cyst excision and adnexectomy, the operative time was shorter, the intraoperative blood loss was less, the postoperative pain was less, the recovery of the gastrointestinal function was faster, and the hospitalization time was less in suspension gasless single port laparoscopic surgery than those in conventional laparoscopic surgery(P<0.05). For patients with hysteromyomectomy and total hysterectomy, the operative time was longer, but the recovery of gastrointestinal function was faster and hospitalization time was less than those in conventional laparoscopic surgery and the postopemtive pain was less in hgsteromyomectomy(P<0.05) and there was no significant difference in intraoperative blood loss between the two groups(P<0.05), Conclusions: Suspension gasless single port laparoscopic surgery in gynecological surgery is safe and feasible. Compared with conventional endoscopic surgery, it has better cosmetic effect, less pain and faster recovery, and is worthy of clinical application.
引文
[1]Piskun G,Rajpal S.Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus[J].J Laparoendosc Adv Surg Tech A,1999,9(4):361-364.
[2]Zhu JF.Scarless endoscopic surgery:NOTES or TUES[J].Surg Endosc,2007,21(10):1898-1899.
[3]Kim KW,Park JI,Nam SH.The feasibility and safety of a three-port laparoscopic cholecytomy using a 2mm mini-instrument[J].Hepatogastroenterology,2013,60(122):281-285.
[4]吴金柱,胡江,梁鲁,等.免气腹悬吊式与传统气腹式腹腔镜胆囊切除术比较分析[J].中国实用外科杂志,2013,33(3):211-213.
[5]张明兴,雒平胤,张少林,等.免气腹经脐单孔腹腔镜在胆囊切除术应用中的临床价值分析[J].医学综述,2014,20(8):1528-1530.
[6]郑民华.NOTES与单孔腹腔镜技术的发展现状与展望[J].中国微创外科杂志,2010,10(1):18-20.
[7]于丽君,张震宇.妇科腹腔镜手术3993例并发症分析[J].中国实用妇科与产科杂志,2012,28(4):290-293.
[8]于兆梅,周克水.经脐单孔免气腹腹腔镜全子宫切除术25例报告[J].腹腔镜外科杂志,2017,22(6):460-462.
[9]马丽.单孔免气腹腹腔镜在妇科手术中的疗效观察[J].河南外科学杂志,2015,21(1):72-73.
[10]吴亚华,田巧先.单孔免气腹腹腔镜在异位妊娠手术中的应用[J].中国美容医学,2012,21(8):200-201.
[11]楮黎,张军.无气腹腹腔镜在41例妇科手术的临床应用[J].实用妇产科杂志.2010,26(11):856-858.
[12]梁军,马文强.悬吊式无气腹腹腔镜在妇科急腹症患者中的应用[J].微创医学,2014,9(6):698-699,704.
[13]肖思建,胡三元,张光永.经脐单孔腹腔镜与传统腹腔镜胆囊切除术的对比研究[J].腹腔镜外科杂志,2010,15(7):501-504.
[14]Buckley FP 3rd,Vassaur H,Monsivais,et al.Comparison of outcomes for single-incision laparoscopic inguinal herniorrhaphy and traditional three-port laparoscopic herniorrhaphy at a single institution[J].Surg Endosc,2014,28(1):30-35.
[15]陈继明,丁屹,杨璐,等.单孔三通道法行单孔腹腔镜手术治疗妇科良性肿瘤[J].中华腔镜外科杂志(电子版),2014,7(5):410-413.
[16]刘南,张光永,胡三元.悬吊式经脐单孔腹腔镜胆囊切除术与传统腹腔镜胆囊切除术的对比研究[J].腹腔镜外科杂志,2011,16(2):95-99.2018-10-08
[2]Zhu JF.Scarless endoscopic surgery:NOTES or TUES[J].Surg Endosc,2007,21(10):1898-1899.
[3]Kim KW,Park JI,Nam SH.The feasibility and safety of a three-port laparoscopic cholecytomy using a 2mm mini-instrument[J].Hepatogastroenterology,2013,60(122):281-285.
[4]吴金柱,胡江,梁鲁,等.免气腹悬吊式与传统气腹式腹腔镜胆囊切除术比较分析[J].中国实用外科杂志,2013,33(3):211-213.
[5]张明兴,雒平胤,张少林,等.免气腹经脐单孔腹腔镜在胆囊切除术应用中的临床价值分析[J].医学综述,2014,20(8):1528-1530.
[6]郑民华.NOTES与单孔腹腔镜技术的发展现状与展望[J].中国微创外科杂志,2010,10(1):18-20.
[7]于丽君,张震宇.妇科腹腔镜手术3993例并发症分析[J].中国实用妇科与产科杂志,2012,28(4):290-293.
[8]于兆梅,周克水.经脐单孔免气腹腹腔镜全子宫切除术25例报告[J].腹腔镜外科杂志,2017,22(6):460-462.
[9]马丽.单孔免气腹腹腔镜在妇科手术中的疗效观察[J].河南外科学杂志,2015,21(1):72-73.
[10]吴亚华,田巧先.单孔免气腹腹腔镜在异位妊娠手术中的应用[J].中国美容医学,2012,21(8):200-201.
[11]楮黎,张军.无气腹腹腔镜在41例妇科手术的临床应用[J].实用妇产科杂志.2010,26(11):856-858.
[12]梁军,马文强.悬吊式无气腹腹腔镜在妇科急腹症患者中的应用[J].微创医学,2014,9(6):698-699,704.
[13]肖思建,胡三元,张光永.经脐单孔腹腔镜与传统腹腔镜胆囊切除术的对比研究[J].腹腔镜外科杂志,2010,15(7):501-504.
[14]Buckley FP 3rd,Vassaur H,Monsivais,et al.Comparison of outcomes for single-incision laparoscopic inguinal herniorrhaphy and traditional three-port laparoscopic herniorrhaphy at a single institution[J].Surg Endosc,2014,28(1):30-35.
[15]陈继明,丁屹,杨璐,等.单孔三通道法行单孔腹腔镜手术治疗妇科良性肿瘤[J].中华腔镜外科杂志(电子版),2014,7(5):410-413.
[16]刘南,张光永,胡三元.悬吊式经脐单孔腹腔镜胆囊切除术与传统腹腔镜胆囊切除术的对比研究[J].腹腔镜外科杂志,2011,16(2):95-99.2018-10-08
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |