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单孔腹腔镜附件手术

Single port access laparoscopic adnexal surgery.

作者信息

Kim Tae-Joong, Lee Yoo-Young, Kim Min Jae, Kim Chul Jung, Kang Heeseok, Choi Chel Hun, Lee Jeong-Won, Kim Byoung-Gie, Bae Duk-Soo

机构信息

Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

J Minim Invasive Gynecol. 2009 Sep-Oct;16(5):612-5. doi: 10.1016/j.jmig.2009.06.011.

Abstract

STUDY OBJECTIVE

To estimate the feasibility, safety, and operative outcomes for the management of adnexal masses by single port access (SPA) laparoscopy with a wound retractor and a surgical glove.

DESIGN

A prospective single-center study (Canadian Task Force classification III).

SETTING

University hospital.

PATIENTS

Twenty-four well selected patients with adnexal masses on imaging scans recruited from June 2008 through January 2009.

INTERVENTIONS

Single port access laparoscopic adnexal surgery.

MEASUREMENTS AND MAIN RESULTS

Single port access laparoscopic adnexal surgery was successfully completed in 22 of 24 patients. The median age of the patients was 45 years (range 23-63 years), and the median body mass index was 22 (range 18-29). The median tumor size was 5 cm (range 3-12 cm). The median operative time was 70 minutes (range 40-128 minutes). The estimated blood loss was minimal (range 10-100mL). The postoperative course was uneventful in all patients. The median postoperative hospital stay was 1 day (range 1-3 days). No postoperative complications were observed at follow-up. The 2 failed cases were as follow: 1 required an additional trocar for adequate adhesiolysis, and the other a staging laparotomy because of the finding of a borderline ovarian malignancy on frozen section pathologic study.

CONCLUSION

The single port access laparoscopic adnexal surgery was safe and feasible and provided almost no visual scar.

摘要

研究目的

评估使用伤口牵开器和手术手套通过单孔腹腔镜手术(SPA)治疗附件包块的可行性、安全性及手术效果。

设计

前瞻性单中心研究(加拿大工作组分类III级)。

地点

大学医院。

患者

2008年6月至2009年1月招募的24例经影像学检查确诊为附件包块的精心挑选患者。

干预措施

单孔腹腔镜附件手术。

测量指标及主要结果

24例患者中有22例成功完成单孔腹腔镜附件手术。患者中位年龄为45岁(范围23 - 63岁),中位体重指数为22(范围18 - 29)。肿瘤中位大小为5cm(范围3 - 12cm)。中位手术时间为70分钟(范围40 - 128分钟)。估计失血量极少(范围10 - 100mL)。所有患者术后恢复顺利。术后中位住院时间为1天(范围1 - 3天)。随访期间未观察到术后并发症。2例失败病例情况如下:1例因粘连严重需额外置入套管针,另1例因术中冰冻切片病理检查发现交界性卵巢恶性肿瘤而行分期剖腹手术。

结论

单孔腹腔镜附件手术安全可行,且几乎不会留下可见疤痕。

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