Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Institute of Women's Life Medical Science, 250 Seongsanno, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Surg Endosc. 2012 May;26(5):1318-24. doi: 10.1007/s00464-011-2030-5. Epub 2011 Nov 2.
The aim of this study was to evaluate the use of single-port laparoscopic surgery in benign gynecologic diseases and to examine its impact on surgical outcomes.
The medical records of 500 consecutive patients who underwent laparotomy or laparoscopic surgery performed by a single surgeon for benign disease from August 2008 to October 2010 were retrospectively reviewed.
The surgeries included hysterectomy (n = 239), adnexectomy (n = 212), and myomectomy (n = 51). The indications for surgery included adnexal lesions (48.1%), uterine fibroids (37.8%), preinvasive cervical disease (7.5%), and endometrial pathology (6.6%). Twenty-nine percent of the first 100 cases were single-port laparoscopic surgeries. The percentages increased in the second (62%), third (72%), fourth (71%), and last (86%) 100 cases. The percentages of laparotomy and multiport laparoscopy were 23% and 48%, respectively, in the first 100 cases; however, in the last 100 cases, the percentages dropped to 4% and 10%, respectively. A significant reduction in estimated blood loss and length of hospital stay was observed for all diseases. No differences were identified in the median operative time or complication rate over the study period.
Single-port laparoscopic surgery can be applied to most benign gynecologic surgery without detrimental effects on clinical outcomes.
本研究旨在评估单孔腹腔镜手术在良性妇科疾病中的应用，并探讨其对手术结果的影响。
回顾性分析 2008 年 8 月至 2010 年 10 月由同一位外科医生行开腹手术或腹腔镜手术治疗的 500 例连续良性疾病患者的病历资料。
手术包括子宫切除术（n=239）、附件切除术（n=212）和子宫肌瘤切除术（n=51）。手术指征包括附件病变（48.1%）、子宫肌瘤（37.8%）、宫颈前病变（7.5%）和子宫内膜病变（6.6%）。前 100 例中有 29%为单孔腹腔镜手术，第二、第三、第四和最后 100 例中分别为 62%、72%、71%和 86%。前 100 例中开腹和多孔腹腔镜手术的比例分别为 23%和 48%，而最后 100 例中则分别降至 4%和 10%。所有疾病的估计出血量和住院时间均显著减少。研究期间，手术时间和并发症发生率的中位数无差异。
单孔腹腔镜手术可应用于大多数良性妇科手术，且不会对临床结果产生不利影响。
