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单切口与多端口机器人子宫肌瘤切除术:手术结果及手术技巧的倾向评分匹配分析

Single-Incision versus Multiport Robotic Myomectomy: A Propensity Score Matched Analysis of Surgical Outcomes and Surgical Tips.

作者信息

Lee Sa-Ra, Kim Ju-Hee, Lee Young-Jae, Lee Shin-Wha, Park Jeong-Yeol, Suh Dae-Shik, Kim Dae-Yeon, Kim Sung-Hoon, Kim Yong-Man, Kim Young-Tak

机构信息

Department of Obstetrics and Gynecology, Seoul Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.

Department of Obstetrics and Gynecology, Gangneung Asan Hospital, University of Ulsan College of Medicine, 38, Bangdonggil, Sacheon-myeon, Gangneung-si 25440, Gangwon-do, Korea.

出版信息

J Clin Med. 2021 Aug 31;10(17):3957. doi: 10.3390/jcm10173957.

Abstract

We aimed to compare the perioperative outcomes of single-incision robotic myomectomy (SIRM) and multiport robotic myomectomy (MPRM) and provide surgical tips. We retrospectively analyzed the medical records of 462 patients with symptomatic leiomyoma who underwent MPRM or SIRM between March 2019 and April 2021. Demographic characteristics and surgical outcomes, including the total operative time (OT), estimated blood loss (EBL), and surgical complication rate, were compared between the two groups. Patients in the SIRM group had lower a body mass index and rate of previous pelvic surgery and were younger than those in the MPRM group. The myoma type was not different between groups; however, the MPRM group had larger, and more myomas than the SIRM group. After propensity score matching, these variables were not significantly different between the groups. The total OT, EBL, difference in hemoglobin levels, transfusion rate, and postoperative fever were not different between the groups. No postoperative complications occurred in the SIRM group. In the MPRM group, one patient needed conversion to laparotomy, and two patients had postoperative complications (umbilical incisional hernia and acute kidney injury). In conclusion, both MPRM and SIRM are feasible and effective surgical options for symptomatic myomas with cosmetic benefits and minimal risk of laparotomy conversion.

摘要

我们旨在比较单切口机器人子宫肌瘤切除术(SIRM)和多端口机器人子宫肌瘤切除术(MPRM)的围手术期结果,并提供手术技巧。我们回顾性分析了2019年3月至2021年4月期间接受MPRM或SIRM的462例有症状子宫肌瘤患者的病历。比较了两组患者的人口统计学特征和手术结果,包括总手术时间(OT)、估计失血量(EBL)和手术并发症发生率。SIRM组患者的体重指数、既往盆腔手术率较低,且比MPRM组患者年轻。两组间肌瘤类型无差异;然而,MPRM组的肌瘤比SIRM组更大、更多。倾向评分匹配后,两组间这些变量无显著差异。两组间的总OT、EBL、血红蛋白水平差异、输血率和术后发热无差异。SIRM组未发生术后并发症。在MPRM组中,1例患者需要转为开腹手术,2例患者出现术后并发症(脐部切口疝和急性肾损伤)。总之,MPRM和SIRM都是治疗有症状肌瘤的可行且有效的手术选择,具有美容优势且开腹手术转换风险最小。

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