Lyapis Anna, Ulrich Amanda, LaMonica Rachel, Kuo Chia-Ling, Kaye Leah, Luciano Danielle
Obstetrics & Gynecology, Fremont, California.
Department of Obstetrics and Gynecology, University of Connecticut, Farmington, Connecticut.
J Minim Invasive Gynecol. 2017 Nov-Dec;24(7):1190-1194. doi: 10.1016/j.jmig.2017.07.020. Epub 2017 Jul 27.
To compare postoperative incisional pain on postoperative days (PODs) 1 and 14 when using a fascial closure device (FCD) versus a traditional fascial closure (TFC) of the 12-mm upper quadrant port during robotic surgery. Time required to close the incision was also compared.
Randomized controlled trial (Canadian Task Force classification I).
Two academic affiliated hospitals, The Hospital of Central Connecticut and The University of Connecticut.
Women undergoing robotic surgery for benign indications by minimally invasive gynecologists at our institutions between November 2012 and October 2014 were enrolled in the study at their preoperative visit.
Patients were randomized to either an FCD or TFC immediately before closure of the fascial incision. Pain score using a 10-point analog pain scale was recorded on POD 1 and POD 14. Time to close the fascial incision, length of surgery, and body mass index were also recorded.
Sixty-seven patients were enrolled, and 65 were randomized at the time of the fascial closure, whereas 2 enrolled patients converted to laparotomy. Statistical analysis demonstrated that pain scores differed by fascial closure technique. Mean pain scores on POD 1 were 3.43 ± 2.48 and 2.06 ± 2.03 for the FCD and TFC, respectively (p = .028). On POD 14 the mean pain scores were 1.97 ± 2.48 and .83 ± 1.42 for the FCD and TFC, respectively (p = .102). Times to close fascia were 106.5 ± 102.28 seconds and 141.97 ± 102.85 seconds for the FCD and TFC, respectively (p = .138).
Our study demonstrates that at POD 1 the use of the fascia closure device results in higher pain scores without a significant difference in closure time.
比较机器人手术中使用筋膜闭合装置（FCD）与传统筋膜闭合（TFC）关闭12毫米上象限端口时术后第1天和第14天的切口疼痛情况。同时比较关闭切口所需的时间。
随机对照试验（加拿大工作组分类I级）。
两家学术附属医院，即中央康涅狄格医院和康涅狄格大学医院。
2012年11月至2014年10月期间，在我们机构由微创妇科医生为良性指征进行机器人手术的女性患者在术前访视时被纳入研究。
在筋膜切口闭合前，患者被随机分为FCD组或TFC组。使用10分模拟疼痛量表记录术后第1天和第14天的疼痛评分。还记录了关闭筋膜切口的时间、手术时长和体重指数。
共纳入67例患者，65例在筋膜闭合时被随机分组，另外2例纳入患者转为开腹手术。统计分析表明，疼痛评分因筋膜闭合技术而异。FCD组和TFC组术后第1天的平均疼痛评分分别为3.43±2.48和2.06±2.03（p = 0.028）。术后第14天，FCD组和TFC组的平均疼痛评分分别为1.97±2.48和0.83±1.42（p = 0 .102）。FCD组和TFC组关闭筋膜的时间分别为106.5±102.28秒和141.97±102.85秒（p = 0.138）。
我们的研究表明，在术后第1天，使用筋膜闭合装置会导致更高的疼痛评分，而闭合时间无显著差异。
