Kim Myeong Seon, Choi Chel Hun, Lee Jeong-Won, Kim Byoung-Gie, Bae Duk-Soo, Kim Tae-Joong
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Gynecol Minim Invasive Ther. 2019 Oct 24;8(4):155-159. doi: 10.4103/GMIT.GMIT_3_19. eCollection 2019 Oct-Dec.
The objective of the study is to compare the intra- and post-operative outcomes of laparoendoscopic single-site surgery (LESS) and conventional laparoscopic surgery (CLS) in mature cystic teratoma (MCT) of the ovary.
We reviewed 254 patients who underwent surgery (cystectomy) for ovarian MCT from March 1, 2014, to August 31, 2016. During the study period, 216 patients underwent LESS and 38 patients underwent CLS. The outcome measures included operation time, estimated blood loss, changing hemoglobin (Hb) level, postoperative pain, and complications. Statistical analysis was performed using SPSS 24.
There was no statistically significant difference in age, body mass index, sexual experience, cyst size, operative time, adhesiolysis, preoperative Hb, Hb changes, postoperative pain scores (visual analog scale), hospital days, and complications between the two groups. In emergent situation, the frequency of CLS was high as three cases (7.9%) versus one case (0.5%, = 0.007) with LESS. As the year progressed, the frequency of LESS increased. There were one case of re-operation for bleeding control and transfusion, one case of postoperative peritonitis and transfusion, and one case of postoperative transfusion in LESS. During LESS, additional port(s) was/were created in 13 cases (6.0%, = 0.249).
LESS is not inferior to CLS in MCT surgery, and LESS is useful for the surgery of MCT. Our study demonstrates that LESS confers feasibility, convenience, and safety regarding cystectomy of MCT.
本研究旨在比较腹腔镜单孔手术（LESS）与传统腹腔镜手术（CLS）治疗成熟性卵巢囊性畸胎瘤（MCT）的术中和术后结果。
我们回顾了2014年3月1日至2016年8月31日期间接受卵巢MCT手术（囊肿切除术）的254例患者。在研究期间，216例患者接受了LESS手术，38例患者接受了CLS手术。观察指标包括手术时间、估计失血量、血红蛋白（Hb）水平变化、术后疼痛及并发症。使用SPSS 24进行统计分析。
两组患者在年龄、体重指数、性经验、囊肿大小、手术时间、粘连松解、术前Hb、Hb变化、术后疼痛评分（视觉模拟评分）、住院天数及并发症方面，差异均无统计学意义。在紧急情况下，CLS的发生率较高，为3例（7.9%），而LESS为1例（0.5%，P = 0.007）。随着时间的推移，LESS的发生率增加。LESS组中有1例因出血控制和输血进行了再次手术，1例术后发生腹膜炎并输血，1例术后输血。在LESS手术中，13例（6.0%）患者额外增加了穿刺孔（P = 0.249）。
LESS在MCT手术中并不逊色于CLS，且LESS对MCT手术是有用的。我们的研究表明，LESS在MCT囊肿切除术中具有可行性、便利性和安全性。
