Salamah Kareemah, Abuzaid Mohammed, Abu-Zaid Ahmed
Department of Obstetrics and Gynecology, Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia.
College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
F1000Res. 2017 Sep 7;6:1657. doi: 10.12688/f1000research.12545.1. eCollection 2017.
: Laparoscopy is rapidly replacing laparotomy in the field of gynecologic surgery. Generally, there are limited data concerning the utility of single-incision laparoscopic surgery (SILS) in gynecologic surgery. Specifically, in Saudi Arabia, a third-world country, data are further limited; only one related study has been conducted so far. The purpose of this study is to retrospectively report our single-institutional experience of SILS in terms of feasibility, safety and perioperative outcomes in the management of various gynecologic conditions. The study took place at the Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia. From January 2012 to May 2016, all gynecologic patients who underwent SILS procedures were analyzed for pre-, intra- and post-operative details. SILS was performed using a single multi-port trocar and standard laparoscopic instruments. : A total of 54 patients underwent 66 SILS procedures. The median age and body mass index (BMI) were 36 years and 28.2 kg/m , respectively. Fourteen patients (26%) had ≥ 1 previous abdominal and/or pelvic surgeries. Twenty-four patients (44.4%) were nulliparous. The three most commonly performed SILS procedures were unilateral salpingo-oophorectomy (45.5%) and unilateral ovarian cystectomy (27.3%) and adhesiolysis (6.1%). The median operative time, estimated blood loss and hospital stay were 74 min, 50 ml and 1 day, respectively. Three patients required conversion to laparotomy, as follows: unidentified non-stopping bleeding source (n=1) and endometriosis stage IV resulting in difficult dissection (n=2). One patient developed post-operative incisional hernia that was treated surgically. The median patients' post-operative pain (according to Wong-Baker FACES Foundation pain rating scale) within 4 hours was 2. At 4-week post-operatively, the median wound scar length (measured at outpatient clinic) was 2 cm. : SILS is feasible, safe and associated with acceptable clinical and surgical outcomes.
在妇科手术领域，腹腔镜检查正迅速取代剖腹手术。一般来说，关于单孔腹腔镜手术（SILS）在妇科手术中的效用的数据有限。具体而言，在沙特阿拉伯这个第三世界国家，数据更为有限；到目前为止仅进行了一项相关研究。本研究的目的是回顾性报告我们单机构在SILS治疗各种妇科疾病方面的可行性、安全性和围手术期结果的经验。该研究在沙特阿拉伯利雅得法赫德国王医疗城的妇女专科医院进行。从2012年1月至2016年5月，对所有接受SILS手术的妇科患者的术前、术中和术后细节进行了分析。SILS使用单个多端口套管针和标准腹腔镜器械进行。共有54例患者接受了66例SILS手术。中位年龄和体重指数（BMI）分别为36岁和28.2kg/m²。14例患者（26%）既往有≥1次腹部和/或盆腔手术史。24例患者（44.4%）未生育。最常进行的三种SILS手术是单侧输卵管卵巢切除术（45.5%）、单侧卵巢囊肿切除术（27.3%）和粘连松解术（6.1%）。中位手术时间、估计失血量和住院时间分别为74分钟、50毫升和1天。3例患者需要转为剖腹手术，情况如下：未识别出的不停血出血源（n = 1）和IV期子宫内膜异位症导致手术分离困难（n = 2）。1例患者发生术后切口疝，接受了手术治疗。术后4小时患者的中位疼痛（根据Wong-Baker面部表情疼痛评分量表）为2分。术后4周，门诊测量的中位伤口瘢痕长度为2厘米。SILS是可行、安全的，且具有可接受的临床和手术结果。
