Ouyang Z, Sun J P, Tian X L, Zhai J J
Department of Gynecology and Obstetrics, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2018 Jun 5;98(21):1713-1716. doi: 10.3760/cma.j.issn.0376-2491.2018.21.018.
To explore the entrance and suture method of umbilical incision in gynecological laparoscopy. A total of 204 cases of gynecologic laparoscopy in our hospital from 2013 to 2016 were reviewed respectively. All the cases used two kinds of approach of umbilical incision: intra-umbilical incision and peri-umbilical incision (longitudinal/transverse oblique/arc incision according to the bellybutton natural skin folds) and two methods of suture: the suture of "U" and the suture of the whole subcutaneous tissue. Two groups were randomly assigned based on the entrance and suture method with each group 102 cases. The peri-operative outcomes were compared, including intra-operative and postoperative bleeding, postoperative incision fat liquefaction and infection, incision pain, incision appearance satisfaction and incision healing satisfaction. The difference was statistically significant in the intra-operative and postoperative bleeding between two groups of intra-umbilical incision and peri-umbilical incision (<0.05). There was statistically significant difference in postoperative incision fat liquefaction, infection and incision pain between two groups of the suture of "U" and the suture of the whole subcutaneous tissue (<0.05). The incision appearance satisfaction showed no difference (>0.05), but the difference was statistically significant (<0.05) in the incision healing satisfaction between two groups. The peri-umbilical incision (longitudinal/transverse oblique/arc incision according to the bellybutton natural skin folds) and suture of the whole subcutaneous tissue can be the feasible modified methods with high practicability and security, good cosmetic result. It should be promoted in gynecologic laparoscopy.
探讨妇科腹腔镜手术脐部切口的入路及缝合方法。回顾性分析我院2013年至2016年共204例妇科腹腔镜手术病例。所有病例采用两种脐部切口入路:脐内切口和脐周切口(根据肚脐自然皮肤褶皱行纵/横斜/弧形切口),以及两种缝合方法:“U”形缝合和全皮下组织缝合。根据入路及缝合方法将患者随机分为两组,每组102例。比较两组围手术期结果,包括术中及术后出血、术后切口脂肪液化及感染、切口疼痛、切口外观满意度及切口愈合满意度。两组脐内切口与脐周切口术中及术后出血差异有统计学意义(<0.05)。两组“U”形缝合与全皮下组织缝合术后切口脂肪液化、感染及切口疼痛差异有统计学意义(<0.05)。切口外观满意度差异无统计学意义(>0.05),但两组切口愈合满意度差异有统计学意义(<0.05)。脐周切口(根据肚脐自然皮肤褶皱行纵/横斜/弧形切口)及全皮下组织缝合是可行的改良方法,实用性及安全性高,美容效果好,应在妇科腹腔镜手术中推广。