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单孔(八孔)辅助体外卵巢囊肿切除术治疗大型卵巢囊肿:与传统腹腔镜手术和开腹手术的比较

Single-port (OctoPort) assisted extracorporeal ovarian cystectomy for the treatment of large ovarian cysts: compare to conventional laparoscopy and laparotomy.

作者信息

Chong Gun Oh, Hong Dae Gy, Lee Yoon Soon

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Medical Center, Daegu, South Korea.

Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Medical Center, Daegu, South Korea.

出版信息

J Minim Invasive Gynecol. 2015 Jan;22(1):45-9. doi: 10.1016/j.jmig.2014.06.003. Epub 2014 Jun 11.

DOI:10.1016/j.jmig.2014.06.003
PMID:24928739
Abstract

STUDY OBJECTIVE

To evaluate single-port assisted extracorporeal cystectomy for treatment of large ovarian cysts and to compare its surgical outcomes, complications, and cystic content spillage rates with those of conventional laparoscopy and laparotomy.

DESIGN

Retrospective study (Canadian Task Force classification II-2).

SETTING

University teaching hospital.

PATIENTS

Twenty-five patients who underwent single-port assisted extracorporeal cystectomy (group 1), 33 patients who underwent conventional laparoscopy (group 2), and 25 patients who underwent laparotomy (group 3).

INTERVENTIONS

Surgical outcomes, complications, and spillage rates in group 1 were compared with those in groups 2 and 3.

MEASUREMENTS AND MAIN RESULTS

Patients characteristics and tumor histologic findings were similar in the 3 groups. The mean (SD) largest diameter of ovarian cysts was 11.4 (4.2) cm in group 1, 9.7 (2.3) cm in group 2, and 12.0 (3.4) cm in group 3. Operative time in groups 1 and 2 was similar at 69.3 (26.3) minutes vs 73.1 (36.3) minutes (p = .66); however, operative time in group 1 was shorter than in group 3, at 69.3 (26.3) minutes vs 87.5 (26.6) minutes (p =.02). Blood loss in group 1 was significantly lower than in groups 2 and 3, at 16.0 (19.4) mL vs 36.1 (20.7) mL (p < .001) and 16.0 (19.4) mL vs 42.2 (39.7) mL (p = .005). The spillage rate in group 1 was profoundly lower than in group 2, at 8.0% vs 69.7% (p < .001).

CONCLUSION

Single-port assisted extracorporeal cystectomy offers an alternative to conventional laparoscopy and laparotomy for management of large ovarian cysts, with comparable surgical outcomes. Furthermore, cyst content spillage rate in single-port assisted extracorporeal cystectomy was remarkably lower than that in conventional laparoscopy.

摘要

研究目的

评估单孔辅助体外囊肿切除术治疗大型卵巢囊肿的效果,并将其手术结果、并发症及囊内容物溢出率与传统腹腔镜手术和开腹手术进行比较。

设计

回顾性研究(加拿大工作组分类II-2)。

地点

大学教学医院。

患者

25例行单孔辅助体外囊肿切除术的患者(第1组)、33例行传统腹腔镜手术的患者(第2组)和25例行开腹手术的患者(第3组)。

干预措施

比较第1组与第2组和第3组的手术结果、并发症及溢出率。

测量指标及主要结果

三组患者的特征及肿瘤组织学检查结果相似。第1组卵巢囊肿的平均(标准差)最大直径为11.4(4.2)cm,第2组为9.7(2.3)cm,第3组为12.0(3.4)cm。第1组和第2组的手术时间相似,分别为69.3(26.3)分钟和73.1(36.3)分钟(p = 0.66);然而,第1组的手术时间短于第3组,分别为69.3(26.3)分钟和87.5(26.6)分钟(p = 0.02)。第1组的失血量显著低于第2组和第3组,分别为16.0(19.4)mL与36.1(20.7)mL(p < 0.001)以及16.0(19.4)mL与42.2(39.7)mL(p = 0.005)。第1组的溢出率远低于第2组,分别为8.0%和69.7%(p < 0.001)。

结论

单孔辅助体外囊肿切除术为大型卵巢囊肿的治疗提供了一种替代传统腹腔镜手术和开腹手术的方法,手术结果相当。此外,单孔辅助体外囊肿切除术的囊内容物溢出率明显低于传统腹腔镜手术。

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