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连续100例单孔与多孔腹腔镜子宫肌瘤切除术的比较研究:技术视角

Comparison study of consecutive 100 cases of single port vs. multiport laparoscopic myomectomy; technical point of view.

作者信息

Lee Suk Woo, Park Eun Kyung, Lee Sung Jong, Lee Keun Ho

机构信息

a Department of Obstetrics and Gynecology , Hallym University Sacred Heart Hospital, Hallym University College of Medicine , Anyang , Korea.

b Department of Obstetrics and Gynecology , The Catholic University of Korea , Seoul , Korea.

出版信息

J Obstet Gynaecol. 2017 Jul;37(5):616-621. doi: 10.1080/01443615.2017.1281896. Epub 2017 Apr 10.

Abstract

We report our experience with single-port and multiple-port laparoscopic myomectomy with operative outcomes and surgical skills. Hundred consecutive patients underwent single-port laparoscopic myomectomy (SP-LM) and 69 multi-port laparoscopic myomectomy (MP-LM). The operative outcomes were compared between the two methods. All procedures were successfully completed without conversion to abdominal myomectomy. The mean maximum diameter of the largest myoma was 7.4 (5-13) vs. 6.8 (5-12) cm and the mean number of myomas was 1.7 vs. 1.6 in SP-LM and MP-LM group, respectively. Mean operative time was 134.2 vs. 122.9 min in SP-LM and MP-LM group (p = .109). We showed that SPL myomectomy is a safe and feasible technique compared to MPL myomectomy with respect to postoperative pain, mean operating time, mean estimated blood loss and length of stay. To improve suturing technique of SP-LM, the working instruments were placed external to the telescope with 'micro-triangulation'.

摘要

我们报告了单孔和多孔腹腔镜子宫肌瘤切除术的经验,包括手术结果和手术技巧。连续100例患者接受了单孔腹腔镜子宫肌瘤切除术(SP-LM),69例接受了多孔腹腔镜子宫肌瘤切除术(MP-LM)。比较了两种方法的手术结果。所有手术均成功完成,未转为开腹子宫肌瘤切除术。SP-LM组和MP-LM组中最大肌瘤的平均最大直径分别为7.4(5-13)cm和6.8(5-12)cm,肌瘤的平均数量分别为1.7个和1.6个。SP-LM组和MP-LM组的平均手术时间分别为134.2分钟和122.9分钟(p = 0.109)。我们表明,在术后疼痛、平均手术时间、平均估计失血量和住院时间方面,与MPL子宫肌瘤切除术相比,SPL子宫肌瘤切除术是一种安全可行的技术。为了改进SP-LM的缝合技术,通过“微三角定位”将工作器械放置在腹腔镜外部。

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