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单孔腹腔镜子宫切除术与传统腹腔镜全子宫切除术的手术结局:一项前瞻性随机对照研究。

Operative Outcomes of Single-Incision Laparoscopic Hysterectomy vs Conventional Laparoscopic Total Hysterectomy: A Prospective Randomized Controlled Study.

机构信息

Surgical Oncology Unit, Oncology Center, 68780Mansoura University (OCMU), Egypt.

Department of general surgery, 68780Mansoura University Hospital, Mansoura, Egypt.

出版信息

Surg Innov. 2022 Oct;29(5):590-599. doi: 10.1177/15533506211041892. Epub 2021 Sep 1.

Abstract

. Over time, there was an emerging need to shift from laparotomy to minimally invasive laparoscopic surgery, with the success of laparoscopic surgery in the last decade in gyne-oncology. . This is a prospective randomized controlled trial conducted in Surgical Oncology Unit, Oncology Centre, Mansoura University, in the period between February 2016 and October 2019. Fifty female patients planned for total hysterectomy were randomized into two equal groups; the first underwent conventional laparoscopic hysterectomy (CLH), while the second underwent single-incision laparoscopic hysterectomy (SILH). The mean operative time in the SILH group was 120.00 ± 28.72 minutes vs 103.20 ± 23.04 minutes in the CLH group ( .027). Median hospital stay in the SILH group was 1 day (range: 1-3 days), the same as that in the CLH group, with no statistical significance (= .384). Postoperative pain assessment using the Visual Analogue Scale (VAS) after 6 hours had a median score of 6 (2-8) in the SILH group and 6 (4-7) in the CLH group with significant increase in experienced pain in the SILH group (= .004), while no significant difference was noted after 12 hours and 24 hours in both SILH and CLH groups. . Single-incision laparoscopic hysterectomy (SILH) has similar outcomes when compared to conventional laparoscopic hysterectomy as regard blood loss, hospital stay, conversion to laparotomy, intraoperative and postoperative complications with the disadvantages of longer operative time, increased surgeon's workload, and relatively more postoperative pain.

摘要

随着时间的推移,人们逐渐需要从剖腹手术转向微创腹腔镜手术,过去十年中腹腔镜手术在妇科肿瘤学中的成功也证明了这一点。这是一项在曼苏拉大学肿瘤中心外科肿瘤学系进行的前瞻性随机对照试验,时间为 2016 年 2 月至 2019 年 10 月。50 名计划接受全子宫切除术的女性患者被随机分为两组;第一组接受传统腹腔镜子宫切除术(CLH),第二组接受单切口腹腔镜子宫切除术(SILH)。SILH 组的平均手术时间为 120.00±28.72 分钟,而 CLH 组为 103.20±23.04 分钟(.027)。SILH 组的中位住院时间为 1 天(范围:1-3 天),与 CLH 组相同,无统计学意义(=.384)。SILH 组术后 6 小时使用视觉模拟量表(VAS)评估的术后疼痛中位数评分为 6(2-8),CLH 组为 6(4-7),SILH 组的疼痛明显增加(=.004),而 SILH 和 CLH 组在 12 小时和 24 小时后均无明显差异。与传统腹腔镜子宫切除术相比,单切口腹腔镜子宫切除术(SILH)在出血量、住院时间、中转开腹、术中及术后并发症方面的结果相似,但手术时间较长、术者工作量增加以及术后疼痛相对增加是其缺点。

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