无入路平台经脐单切口腹腔镜与传统多孔腹腔镜行全子宫切除术的临床效果比较

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英文篇名：Comparison of Clinical Effect of Transumbilical Single-incision Laparoscopic Total Hysterectomy without Single Port and Conventional Multi-port Laparoscopic Total Hysterectomy 作者：刘思伟 ; 李元宏 ; 张勇 ; 邹冰玉 ; 雷华江 英文作者：LIU Siwei;LI Yuanhong;ZHANG Yong;Department of Obstetrics and Gynecology,Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital;Department of Obstetrics and Gynecology,Affiliated Hospital of Chengdu University;Department of Obstetrics and Gynecology,Mianyang Central Hospital; 关键词：经脐单切口腹腔镜 ; 单孔腹腔镜 ; 传统多孔腹腔镜 ; 全子宫切除术 英文关键词：Laparoendoscopic single-site surgery;;Transumbilical single-incision laparoscopic surgery;;Conventional multi-port laparoscopic surgery;;Hysterectomy 中文刊名：SFCZ 英文刊名：Journal of Practical Obstetrics and Gynecology 机构：四川省医学科学院·四川省人民医院妇产科;成都市第一人民医院妇产科;成都大学附属医院妇产科;绵阳市中心医院妇产科; 出版日期：2019-02-15 出版单位：实用妇产科杂志 年：2019 期：v.35 语种：中文; 页：SFCZ201902025 页数：4 CN：02 ISSN：51-1145/R 分类号：80-83

摘要

目的:探讨无入路平台经脐单切口腹腔镜(TU-SILS)行全子宫切除术的临床应用价值。方法:将100例诊断为子宫肌瘤、子宫腺肌病、子宫颈上皮内瘤变Ⅲ级及子宫不典型增生,拟入院切除子宫的患者,随机入组;50例行传统多孔腹腔镜(MPLS)全子宫切除术(MPLS组),50例行无入路平台TU-SILS全子宫切除术(TU-SILS组)。观察及比较两组手术时间、术中出血量、术后病率、术后肛门排气时间、住院时间、术后疼痛评分(VAS)以及患者满意度等。结果:两组患者的术中出血量及术后病率差异无统计学意义(P>0.05)。TU-SILS组手术时间长于MPLS组,住院时间短于MPLS组,术后疼痛评分低于MPLS组,术后肛门排气时间快于MPLS组,患者对切口满意度则高于MPLS组,两组差异均有统计学意义(P<0.05)。所有手术顺利完成,术中、术后均未出现严重并发症、均未中转开腹,亦无手术死亡病例。结论:与MPLS比较,无入路平台TU-SILS全子宫切除是一种安全、可行的手术方式,且可以达到与单孔腹腔镜一样满意的美容效果和无瘢痕的手术目的。
        Objective:To evaluate the clinical value of transumbilical single-incision laparoscopic total hysterectomy without single port.Methods:100 cases with uterine fibroid,adenomyosis,Ⅲ stage cervical intraepithelial lesion or uterine dysplasia admitted to total hysterectomy were divided into two groups randomly.The TU-SILS group(50 cases) was treated by transumbilical single-incision laparoscopic total hysterectomy without single port.The MPLS group(50 cases) was treated by conventional laparoscopic total hysterectomy.The operative time,intraoperative blood loss,postoperative morbidity,postoperative anal exhaust time,the hospitalization time,VAS score and patients′satisfaction were compared between the two groups.Results:There was no significant difference of intraoperative blood loss and postoperative morbidity between the two groups(P>0.05).The time of operation in the TU-SILS group was longer than that of the MPLS group(P<0.05).The time of hospitalization,the postoperative pain score,the postoperative anal exhaust time and the patients′ satisfaction were significantly improved in the TU-SILS group than those in the MPLS group(P<0.05).The operation was successful in all cases without postoperative complications,deaths or failures.Conclusions:Transumbilical single-incision laparoscopic surgery without single port is a safe and feasible way for hysterectomy.It could be as satisfactory as laparoendoscopic single-site surgery for the purpose of cosmetic and scar-free surgery.It should be more easily accepted by the patients.

引文

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