[1]王　倩,李婷婷,罗　晶,等.改良经脐单孔腹腔镜手术治疗较大和巨大卵巢良性肿瘤疗效观察[J].新乡医学院学报,2022,39(7):642-647.[doi:10.7683/xxyxyxb.2022.07.009]
　WANG Qian,LI Tingting,LUO Jing,et al.Effect of modified transumbilical single-hole laparoscopic surgery in the treatment of large and giant benign ovarian tumor[J].Journal of Xinxiang Medical University,2022,39(7):642-647.[doi:10.7683/xxyxyxb.2022.07.009]
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改良经脐单孔腹腔镜手术治疗较大和巨大卵巢良性肿瘤疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年7
页码:
642-647
栏目:
临床研究
出版日期:
2022-07-05

文章信息/Info

Title:
Effect of modified transumbilical single-hole laparoscopic surgery in the treatment of large and giant benign ovarian tumor
作者:
王　倩; 李婷婷; 罗　晶; 侯瑞杰; 尹夕瑶; 杜　昕; 秦海霞
（新乡医学院第一附属医院妇产科，河南　卫辉　453100）
Author(s):
WANG Qian; LI Tingting; LUO Jing; HOU Ruijie; YIN Xiyao; DU Xin; QIN Haixia
(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
卵巢良性肿瘤; 改良经脐单孔腹腔镜手术; 经脐单孔腹腔镜手术; 传统腹腔镜手术
Keywords:
benign ovarian tumor; modified transumbilical single-hole laparoscopic surgery; transumbilical single-hole laparoscopic surgery; traditional laparoscopic surgery
分类号:
R737.31
DOI:
10.7683/xxyxyxb.2022.07.009
文献标志码:
A
摘要:
目的　探讨改良经脐单孔腹腔镜手术治疗较大和巨大卵巢良性肿瘤的临床效果。方法　选择2019年10月至2021年4月新乡医学院第一附属医院收治的118例肿瘤直径≥8 cm的卵巢良性肿瘤患者为研究对象，根据手术方式将患者分为传统腹腔镜组（n=40）、经脐单孔腹腔镜组（n=39）和改良经脐单孔腹腔镜组（n=39）。传统腹腔镜组患者采用传统腹腔镜手术治疗，经脐单孔腹腔镜组患者采用经脐单孔腹腔镜手术治疗，改良经脐单孔腹腔镜组患者采用改良经脐单孔腹腔镜手术治疗。记录并比较3组患者手术时间、术中出血量、术后最高体温、术后首次排气时间、术后住院时间；采用数字评价量表（NRS）评估3组患者术后24 h疼痛情况；术后1个月采用身体意象问卷中美容量表（CS）评分评估3组患者对术后切口瘢痕美观满意度。分别于术前、术后1个月采用放射免疫分析法检测血清雌二醇（E2）、卵泡刺激素（FSH）及黄体生成素（LH）水平。比较3组患者术后发热、切口愈合不良及月经异常等并发症发生情况。结果　改良经脐单孔腹腔镜组患者手术时间显著短于经脐单孔腹腔镜组和传统腹腔镜组，术中出血量显著少于经脐单孔腹腔镜组和传统腹腔镜组（P<0.05）；经脐单孔腹腔镜组与传统腹腔镜组患者手术时间、术中出血量比较差异无统计学意义（P>0.05）。改良经脐单孔腹腔镜组和经脐单孔腹腔镜组患者术后首次排气时间、术后住院时间均显著短于传统腹腔镜组，NRS评分显著低于传统腹腔镜组，CS评分显著高于传统腹腔镜组（P<0.05）。改良经脐单孔腹腔镜组与经脐单孔腹腔镜组患者术后首次排气时间、术后住院时间及NRS、CS评分比较差异无统计学意义（P>0.05）。3组患者术后最高体温比较差异无统计学意义（P>0.05）。术前，3组患者血清E2、FSH、LH水平比较差异无统计学意义（F=0.208、0.015、0.016，P>0.05）。术后1个月，改良经脐单孔腹腔镜组患者血清E2水平显著高于经脐单孔腹腔镜组与传统腹腔镜组，血清LH、FSH水平显著低于经脐单孔腹腔镜组与传统腹腔镜组（P<0.05）；经脐单孔腹腔镜组与传统腹腔镜组患者血清E2、FSH、LH水平比较差异无统计学意义（P>0.05）。3组患者术后1个月血清E2水平显著低于术前，血清LH、FSH水平显著高于术前（P<0.05）。传统腹腔镜组患者术后并发症发生率为17.50%（7/40），经脐单孔腹腔镜组患者术后并发症发生率为15.38%（6/39），改良经脐单孔腹腔镜组患者术后并发症发生率为2.56%（1/39）。改良经脐单孔腹腔镜组患者术后并发症发生率显著低于经脐单孔腹腔镜组和传统腹腔镜组（χ2=3.924、4.840，P<0.05）；经脐单孔腹腔镜组与传统腹腔镜组患者术后并发症发生率比较差异无统计学意义（χ2=0.064，P>0.05）。结论　改良经脐单孔腹腔镜手术治疗较大和巨大卵巢良性肿瘤具有手术时间短、术中出血量少，患者术后疼痛轻、对术后切口瘢痕美观满意度高，且对卵巢功能损伤小、术后并发症发生率低的优势。
Abstract:
Objective　To investigate the clinical effect of modified transumbilical single-hole laparoscopic surgery in the treatment of large and giant benign ovarian tumor.Methods　A total of 118 patients with benign ovarian tumor with tumor diameter≥8 cm admitted to the First Affiliated Hospital of Xinxiang Medical University from October 2019 to April 2021 were selected as research objects,and they were divided into the traditional laparoscopic group (n=40),transumbilical single-hole laparoscopic group (n=39) and modified transumbilical single-hole laparoscopic group (n=39)according the surgical method.The patients in the traditional laparoscopic group were treated with the traditional laparoscopic surgery,the patients in the transumbilical single-hole laparoscopic group were treated with transumbilical single-hole laparoscopic surgery,and the patients in the modified transumbilical single-hole laparoscopic group were treated with a modified transumbilical single-hole laparoscopic surgery.The operation time,intraoperative blood loss,postoperative maximum body temperature,first postoperative exhaust time and postoperative hospital stay time were recorded and compared among the three groups;the 24-hours postoperative pain of the patients in the three groups was assessed by the numerical rating scale (NRS);one month after operation,the patients′ satisfaction with the beauty of incision scar in the three groups was evaluated by the cosmetic scale (CS) score of body image questionnaire.The levels of serum estradiol (E2),follicle stimulating hormone (FSH) and luteinizing hormone (LH) of the patients in the three groups were detected by radioimmunoassay before operation and one month after operation.The postoperative complications including fever,poor wound healing and abnormal menstruation of patients were compared among the three groups.Results　The operation time of patients in the modified transumbilical single-hole laparoscopic group was significantly shorter than that in the trunsumbilical single-hole laparoscopic group and traditional laparoscopic group,the intraoperative blood loss was significantly less than that in the transumbilical single-hole laparoscopic group and traditional laparoscopic group (P<0.05);there was no significant difference in operation time and intraoperative blood loss of patients between the transumbilical single-hole laparoscopic group and the traditional laparoscopic group (P>0.05).The first postoperative exhaust time and postoperative hospital stay time in the modified transumbilical single-hole laparoscopic group and the transumbilical single-hole laparoscopic group were significantly shorter than those in the traditional laparoscopic group,and the NRS score was significantly lower than that in the traditional laparoscopy group,and the CS score was significantly higher than that in the traditional laparoscopic group (P<0.05).There was no significant difference in the first postoperative exhaust time,postoperative hospital stay and NRS,CS scores of patients between the modified transumbilical single-hole laparoscopic group and the transumbilical single-hole laparoscopic group (P>0.05).There was no significant difference in the highest postoperative temperature of patients among the three groups (P>0.05).Before operation,there was no significant difference in serum E2,FSH and LH levels of patients among the three groups (F=0.208,0.015,0.016;P>0.05).One month after operation,the serum E2 level of patients in the modified transumbilical single-hole laparoscopic group was significantly higher than that in the transumbilical single-hole laparoscopic group and the traditional laparoscopic group,and the serum LH and FSH levels of patients were significantly lower than those in the transumbilical single-hole laparoscopic group and the traditional laparoscopic group (P<0.05);there was no significant difference in serum E2,FSH and LH levels of patients between the transumbilical single-hole laparoscopic group and the traditional laparoscopic group (P>0.05).One month after operation,the serum E2 level of patients in the three groups was significantly lower than that before operation,and the serum LH and FSH levels were significantly higher than those before operation (P<0.05).The incidence of postoperative complications of patients in the traditional laparoscopic group was 17.50% (7/40),the incidence of postoperative complications of patients in the transumbilical single-hole laparoscopic group was 15.38% (6/39),and the incidence of postoperative complications of patients in the modified transumbilical single-hole laparoscopic group was 2.56%(1/39).The incidence of postoperative complications of patients in the modified transumbilical single-hole laparoscopic group was significantly lower than that in the transumbilical single-hole laparoscopic group and the traditional laparoscopic group (χ2=3.924,4.840;P<0.05);there was no significant difference in the incidence of postope-rative complications of patients between the transumbilical single-hole laparoscopic group and the traditional laparoscopic group (χ2=0.064,P>0.05).Conclusion　The modified transumbilical single-hole laparoscopic surgery in the treatment of large and giant benign ovarian tumors has the advantages of short operation time,less intraoperative bleeding,less postoperative pain,high satisfaction with the beauty of postoperative incision scar,less damage to ovarian function and less postoperative complications incidence.

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[1]邹心忠.腹腔镜下卵巢良性肿瘤剥除术27例分析[J].新乡医学院学报,2001,18(03):212.

更新日期/Last Update: 2022-07-05