作者单位：528000 佛山，广东省佛山市妇幼保健院

经脐单孔腹腔镜手术治疗卵巢良性肿瘤的研究

黄晓斌柳晓春郑玉华

【摘要】目的探讨经脐单孔腹腔镜卵巢良性肿瘤剥除术的可行性。方法选择行经脐单孔腹腔镜卵巢良性肿瘤剥除术患者32例(A组)，及同期行传统腹腔镜卵巢良性肿瘤剥除术患者45例(B组)，肿瘤最大径线均≤6 cm。对2组患者的临床资料进行比较分析。结果2组均顺利完成手术。B组手术时间短于A组(45.09±9.65 min vs.56.75±11.31 min ，t=-4.862，P<0.001)，术中出血量少于A组(19.73±7.60 ml vs.28.72±10.16 ml，t=-4.444，P<0.001)，囊肿破裂率低于A组(χ2=9.397，P=0.002)，术后第一天疼痛Prince-Henry 5级评分法疼痛程度弱于A组(Z=-2.945,P=0.003)，术后24 h内肛门排气率高于A组(χ2=7.022，P=0.008)，2组比较差异均有统计学意义；2组术中、术后均无并发症，2组术中卵巢创面缝合比例、术后止痛药使用比例比较，差异无统计学意义(P>0.05)。结论尽管经脐单孔腹腔镜卵巢囊肿剥除术具备隐藏瘢痕、美容、微创的优点，但其操作难度明显增加，目前尚难广泛应用。

【关键词】经脐单孔腹腔镜；腹腔镜；卵巢良性肿瘤

DOI:10.3969/g.issn.0253-9802.2015.07.015

通讯作者，郑玉华，E-mail：zyh2013916@163.com

Abstract【】ObjectiveTo investigate the feasibility of transumbilical laparoendoscopic single-site surgery (LESS) in a cystectomy for benign ovarian tumors. MethodsThis study included 32 patients with benign ovarian tumors who underwent a cystectomy via transumbilical LESS (Group A) and 45 patients who were treated with a conventional laparoscopic oophorocystectomy for benign ovarian tumors (Group B). The maximum diameters of the tumors were 6 cm or less. The clinical data of the patients in these two groups were compared for analysis. ResultsThe operations were successful for all patients in both groups. The operative time in Group A was longer than that in Group B (56.75±11.31 min vs. 45.09±9.65 min, t=4.862, P<0.001). The intraoperative blood loss in Group A was greater than that in Group B (28.72±10.16 ml vs. 19.73±7.60 ml, t=4.444，P<0.001). Group A had a higher rate of intraoperative cyst rupture than Group B (χ2=9.397, P=0.002). Using the Prince-Henry pain scale, the pain score within the first 24 hours after surgery in Group A was higher than that in Group B (Z=-2.945, P=0.003). Group A had a higher rate of gas passage through the rectum within the first 24 hours after surgery than Group B (χ2=7.022, P=0.008). The differences observed between the two groups were all statistically significant. No intraoperative or postoperative complications occurred in either group. No statistically significant differences were observed in intraoperative ovarian wound closure or the postoperative use of analgesics (P>0.05). ConclusionsDespite its advantages of scar concealment, cosmetic benefits, and minimally invasive nature, transumbilical LESS has not been widely used in cystectomies due to the increased difficulty of the procedure.

收稿日期：(2015-02-06)

A study on transumbilical laparoendoscopic single-site surgery for benign ovarian tumorsHuangXiaobin,LiuXiaochun,ZhengYuhua.DepartmentofGynecology，MaternityandInfantHealthHospitalofFoshan,Foshan528000,China

Correspondingauthor，ZhengYuhua，E-mail:zyh2013916@163.com

【Key words】Laparoendoscopic single-site surgery; Ovarian tumor; Laparoscopy

随着腹腔镜技术的快速发展，早在10余年前腹腔镜手术治疗卵巢良性肿瘤的技术已成熟，是安全而有效的方法，但需取3～4个切口，且经1 cm切口取出标本困难[1]。经脐单孔腹腔镜(LESS)最早应用于妇科绝育术，近10年来始在妇科获得进一步发展，在附件手术的应用已明显增多[2]。我院妇科近3年来进行单孔腹腔镜技术在妇科的应用研究，发现LESS卵巢囊肿剥除术具有微创、隐藏手术瘢痕、术后美容效果好、易于取出标本的优点，但手术时间偏长、术中囊肿破例率较高，术中缝合难度较大，只能部分开展。现将LESS、传统多孔法腹腔镜剥除卵巢良性肿瘤的资料进行回顾性比较分析。

对象与方法

一、研究对象

选择2012年7月至2014年12月在我院完成的32例经LESS下卵巢良性肿瘤剥除术患者(A组)，并选择同期行传统多孔法腹腔镜卵巢良性肿瘤剥除术(B组)患者45例，2组患者肿瘤最大径线≤6 cm，手术均由作者完成。……