常规器械经脐单孔腹腔镜手术在妇科良性疾病中的临床应用

目的:探讨经脐单孔腹腔镜手术(LESS)在妇科良性疾病中的临床价值。方法:选择2018年1月-2019年4月在我院妇科行经脐单孔腹腔镜手术的68例患者为研究组,同期同病种行传统多孔腹腔镜手术的70例患者为对照组,比较2组的术中出血量、术后最高体温、术后肛门排气时间、术后下床活动时间、术后住院时间、术后24 h疼痛视觉模拟评分(VAS)、体象量表BIS评分和切口美观满意度CS评分、手术时间及围手术期并发症的指标。结果:2组患者手术均顺利完成,术中不需要辅助操作,未中转开腹。术中、术后均未出现严重的手术并发症。2组患者在术中出血量、术后最高体温、术后排气时间、术后下床活动时间、术后住院时间差异无统计学意义(P>0.05);手术时间、术后24 h VAS评分、体象量表BIS评分和切口美观满意度CS评分比较差异有统计学意义(P<0.05)。结论:常规器械经脐单孔腹腔镜不需要特殊的器械和设备,符合卫生经济学特点;具有良好的美容效果,以及标本取出方便的优势,LESS应用于妇科良性疾病是安全可行的。

The Clinical Application of Laparoendoscopic Single-Port Surgery with Conventional Instruments in the Treatment of Benign Gynecological Diseases

Objective:To probe into the clinical value of laparoendoscopic single-port surgery(LESS) in the treatment of benign gynecological disease. Methods:68 patients who underwent transumbilical single-port laparoscopic surgery at the gynecological department of our hospital between January 2018 and April 2019 were selected as the research group, and another 70 patients with same diseases who underwent conventional multiple ports laparoscopic surgery were chosen as the control group. The indexes such as intraoperative bleeding volume, highest postoperative body temperature, postoperative time for passage of gas by anus, postoperative out of bed activity time, postoperative hospitalized duration, 24 h postoperative VAS, BIS(body image scale) score and incision aesthetic satisfaction CS score, surgical duration and perioperative complications in both groups were compared.Results:The surgeries for patients in both groups were completed smoothly, no intraoperative assisted manipulation was needed and no conversion to laparotomy was done. No severe intraoperative or postoperative complications occurred. There were no significant differences between the intraoperative bleeding volume, highest postoperative body temperature, postoperative time for passage of gas by anus, postoperative activity time, postoperative hospitalized duration in both groups(P>0.05). However, the differences between surgical duration, 24 h postoperative VAS among patients,body image scale BIS score and incision aesthetic satisfaction CS score were statistically significant(P<0.05). Conclusions: The transumbilical single-port laparoscopy with conventional instruments do not need special instruments or devices, which conforms to the characteristics of health economics;it is equipped with good cosmetic effect and the advantage of convenient specimen extraction;the application of LESS in the treatment of benign gynecological diseases is safe and feasible.