Women's Cancer Clinic, Severance Hospital, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.
Am J Obstet Gynecol. 2010 Jul;203(1):26.e1-6. doi: 10.1016/j.ajog.2010.02.026. Epub 2010 Apr 24.
The objective of the study was to compare surgical outcomes and postoperative pain between transumbilical single-port access total laparoscopic hysterectomy (SPA-TLH) and conventional 4-port total laparoscopic hysterectomy (TLH).
We retrospectively reviewed 157 patients who underwent SPA-TLH (n = 52) or conventional TLH (n = 105). A single-port access system consisted of a wound retractor, surgical glove, 2 5 mm trocars, and 1 10/11 mm trocar.
The SPA-TLH group had less intraoperative blood loss (P < .001), shorter hospital stay (P = .001), and earlier diet intake (P < .001) compared with the conventional TLH group. There was no difference in perioperative complications. Immediate postoperative pain score was lower in the SPA-TLH group (P < .001). Postoperative pain after 6 and 24 hours was lower in SPA-TLH with marginal statistical significance.
SPA-TLH is a feasible method for hysterectomy with lower immediate postoperative pain and better surgical outcomes with respect to recovery time compared with conventional TLH.
本研究旨在比较经脐单孔通道全腹腔镜子宫切除术（SPA-TLH）与传统四孔全腹腔镜子宫切除术（TLH）的手术结果和术后疼痛。
我们回顾性分析了 157 例接受 SPA-TLH（n=52）或传统 TLH（n=105）的患者。单孔通道系统由切口牵开器、手术手套、2 个 5mm 套管和 1 个 10/11mm 套管组成。
与传统 TLH 组相比，SPA-TLH 组术中出血量更少（P<.001），住院时间更短（P=.001），饮食摄入更早（P<.001）。两组围手术期并发症无差异。SPA-TLH 组即刻术后疼痛评分较低（P<.001）。SPA-TLH 组术后 6 小时和 24 小时的疼痛评分较低，但差异无统计学意义。
与传统 TLH 相比，SPA-TLH 是一种可行的子宫切除术方法，具有较低的即刻术后疼痛和更好的手术结果，恢复时间更快。
