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单孔腹腔镜与传统腹腔镜治疗附件良性疾病的疼痛比较:一项单中心随机对照研究。

Is single-port laparoscopy for benign adnexal disease less painful than conventional laparoscopy? A single-center randomized controlled trial.

机构信息

Department of Obstetrics and Gynecology, Sorlandet Hospital Health Authority, Kristiansand, Norway.

出版信息

Fertil Steril. 2012 Oct;98(4):973-9. doi: 10.1016/j.fertnstert.2012.06.016. Epub 2012 Jul 4.

Abstract

OBJECTIVE

To determine whether laparo-endoscopic single-site surgery (LESS) results in less postoperative pain and a better cosmetic surgical scar compared with conventional laparoscopy.

DESIGN

Prospective randomized controlled trial.

SETTING

A county hospital in Norway.

PATIENT(S): Forty women with benign adnexal disease or a hereditary cancer risk scheduled for laparoscopic adnexal surgery.

INTERVENTION(S): LESS or conventional laparoscopy.

MAIN OUTCOME MEASURE(S): Postoperative pain 24 hours after surgery.

RESULT(S): There was no difference in pain at 24 hours after surgery, with a mean score of 3.0 (SD 2.1) in the LESS group and 2.5 (SD 1.5) in the conventional laparoscopy group. Significantly more shoulder tip pain was reported by women undergoing LESS compared with those having conventional surgery at 6 and 24 hours after surgery. A high satisfaction with the cosmetic result was reported in both groups, with no significant difference in the Manchester scar scale score.

CONCLUSION(S): Although similar levels of postoperative pain are experienced by women having LESS and conventional laparoscopic surgery, women having LESS report significantly more shoulder tip pain compared to those having conventional laparoscopic surgery. This may relate to a significantly longer operation time in the LESS group.

CLINICAL TRIAL REGISTRATION NUMBER

NCT01288599.

摘要

目的

比较经脐单孔腹腔镜手术(LESS)与传统腹腔镜手术治疗附件良性疾病或遗传性癌风险患者的术后疼痛和美容切口效果。

设计

前瞻性随机对照试验。

地点

挪威某县医院。

患者

40 例拟行腹腔镜附件手术的良性附件疾病或遗传性癌风险患者。

干预措施

LESS 或传统腹腔镜手术。

主要观察指标

术后 24 小时的疼痛程度。

结果

两组术后 24 小时的疼痛评分无差异,LESS 组平均评分为 3.0(SD 2.1),传统腹腔镜组为 2.5(SD 1.5)。术后 6 小时和 24 小时,行 LESS 手术的患者肩部疼痛明显多于行传统腹腔镜手术的患者。两组患者对美容效果均非常满意,曼彻斯特瘢痕量表评分无显著差异。

结论

LESS 与传统腹腔镜手术患者的术后疼痛程度相似,但行 LESS 手术的患者肩部疼痛明显多于行传统腹腔镜手术的患者,可能与 LESS 组手术时间较长有关。

临床试验注册号

NCT01288599。

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