摘要
目的探讨单孔腹腔镜技术在妇科良性病变手术中应用的可行性。方法将2010年4~10月10例单孔腹腔镜妇科手术与同期20例常规腹腔镜妇科手术进行比较。单孔腹腔镜手术在脐轮正中做一纵切口,穿刺插入有3个操作孔道的穿刺套管（Triport）,建立气腹,压力为12~13 mm Hg。Triport的3个孔道插入腹腔镜探头及操作器械进行手术,手术操作同常规腹腔镜。结果 2组手术均获成功,单孔腹腔镜组手术时间（53.5±10.6）min显著长于常规腹腔镜组（38.2±8.1）min（t=4.399,P=0.000）;单孔腹腔镜组术中出血量（31.5±16.7）ml与常规腹腔镜组（36.0±16.8）ml无显著差异（t=-0.693,P=0.494）;单孔腹腔镜组排气时间（34.1±5.9）h与常规腹腔镜组（34.3±6.4）h无显著差异（t=-0.693,P=0.494）;单孔腹腔镜组住院时间（3.1±0.6）d与常规腹腔镜组（3.2±0.9）d无显著差异（t=0.317,P=0.754）;单孔腹腔镜组术后病率（2/10,20%）与常规腹腔镜组（3/20,15%）无显著差异（Z=-0.173,P=0.862）。2组患者均无术中术后并发症发生。30例随访1~6个月,均无切口疝、出血、术后伤口感染等并发症。结论单孔腹腔镜技术尚处于起步阶段,手术有一定难度,手术时间延长,仍然是可以接受的。单孔腹腔镜技术对患者体表创伤更小,安全可行,美容效果佳。
Objective To investigate the feasibility of laparoendoscopic single-site surgery（LESS） for benign gynecological diseases. Methods From April to October 2010,we perfomed LESS on 10 patients.The results of the operation were compared with 20 cases of conventional laparoscopy that were performed at the mean time.During the LESS,a vertical incision was made at the middle of the umbilicus,then a triport was inserted to establish pneumoperitoneum（12-13 mm Hg）.Once the laparoscope and instruments were in place,the procedure was similar to that of conventional group. Results All the procedures were performed successfully in the both groups.The mean operation time of the LESS group [（53.5±10.6） min] was significantly longer than that of conventional group [（38.2±8.1） min;t=4.399,P=0.000].Whereas,no significant difference was observed in intraoperative blood loss,recovery time of gastrointestinal function,hospital stay,and postoperative morbidity [（31.5±16.7） ml vs.（36.0±16.8） ml,t=-0.693,P=0.494;（34.1±5.9） h vs.（34.3±6.4） h,t=-0.693,P=0.494;（3.1±0.6） d vs.（3.2±0.9） d,t=0.317,P=0.754;and 20% vs.15%,Z=-0.173,P=0.862] between the two groups.None of the groups showed postoperative complications.The 30 patients were followed up for 1 to 6 months,during which no incisional hernia,hemorrhage,or incisional infection occurred. Conclusions In spite of the technical difficulties in the initial stage,LESS is safe and feasible.It is less invasive than conventional laparoscopy with a good cosmetic outcome.
出处
《中国微创外科杂志》
CSCD
2011年第2期155-158,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
单孔腹腔镜手术
经脐入路
妇科手术
Laparoendoscopic single-site surgery
Transumbilical route
Gynecologic operation
