Choi Chel Hun, Kim Tae-Hyun, Kim Seo-Hee, Choi June-Kuk, Park Jin-Young, Yoon Aera, Lee Yoo-Young, Kim Tae-Joong, Lee Jeong-Won, Kim Byoung-Gie, Bae Duk-Soo
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Minim Invasive Gynecol. 2014 Jul-Aug;21(4):580-5. doi: 10.1016/j.jmig.2013.12.096. Epub 2013 Dec 31.
To introduce a new technique of laparoscopic myomectomy (LM) using single-port access and a modified suture technique.
Retrospective review of medical records.
University medical center.
From October 2011 through December 2012, 55 consecutive patients underwent single-port LM using a modified suture technique with Hem-o-lock ligation clips and myoma morcellation through the umbilical incision site (Choi's LM). As a historic control, patients who underwent conventional multi-port LM from January 2008 through November 2010 were included in the study.
Medical records for 157 patients (55 Choi's LM and 102 LM) were reviewed retrospectively. Inclusion criteria were <3 symptomatic myomas ≤10 cm. Outcomes measured were operative time, estimated blood loss, complications, length of postoperative hospital stay, and postoperative pain.
Age, symptoms resulting from myomas, location and type of dominant myomas, and number of myomas were similar in the 2 groups. There were no significant differences in mean diameter of the myomas between the groups (6.8 cm vs 7.0 cm; p = .40). The mean duration of the operation was shorter in the Choi's LM group compared with the conventional LM group (104 min vs 152 min; p < .001). Choi's LM also resulted in a statistically significant decrease in blood loss (139 mL vs 222 mL; p < .001). Postoperative pain scores were significantly lower in the Choi's LM group than in the conventional LM group at 1, 6, 12, and 24 hours after surgery.
Choi's LM with modified suture technique is associated with shorter operative time and less postoperative pain. A prospective trial is needed to confirm the results.
介绍一种使用单孔入路和改良缝合技术的腹腔镜子宫肌瘤切除术（LM）新技术。
病历回顾性研究。
大学医学中心。
2011年10月至2012年12月，55例连续患者采用改良缝合技术、Hem-o-lock结扎夹及通过脐部切口部位进行肌瘤粉碎术，接受了单孔腹腔镜子宫肌瘤切除术（Choi氏腹腔镜子宫肌瘤切除术）。作为历史对照，2008年1月至2010年11月接受传统多孔腹腔镜子宫肌瘤切除术的患者纳入本研究。
对157例患者（55例Choi氏腹腔镜子宫肌瘤切除术和102例腹腔镜子宫肌瘤切除术）的病历进行回顾性分析。纳入标准为<3个有症状的肌瘤且最大直径≤10厘米。测量的结果包括手术时间、估计失血量、并发症、术后住院时间和术后疼痛。
两组患者的年龄、肌瘤引起的症状、主要肌瘤的位置和类型以及肌瘤数量相似。两组间肌瘤的平均直径无显著差异（6.8厘米对7.0厘米；p = 0.40）。与传统腹腔镜子宫肌瘤切除术组相比，Choi氏腹腔镜子宫肌瘤切除术组的平均手术时间更短（104分钟对152分钟；p < 0.001）。Choi氏腹腔镜子宫肌瘤切除术还使失血量在统计学上显著减少（139毫升对222毫升；p < 0.001）。术后1、6、12和24小时，Choi氏腹腔镜子宫肌瘤切除术组的术后疼痛评分显著低于传统腹腔镜子宫肌瘤切除术组。
采用改良缝合技术的Choi氏腹腔镜子宫肌瘤切除术与较短的手术时间和较少的术后疼痛相关。需要进行前瞻性试验来证实这些结果。
