Graduate School, 36674Dalian Medical University, Dalian Medical University, Dalian, Liaoning, China.
Department of Gynaecology, Shenyang Women's and Children's Hospital, Shenyang, Liaoning, China.
J Int Med Res. 2021 Oct;49(10):3000605211053985. doi: 10.1177/03000605211053985.
To estimate the safety and feasibility of laparoendoscopic single-site surgery (LESS) in pregnant patients with acute abdomen.
Baseline characteristics, surgical results, and obstetric and neonatal outcomes were retrospectively compared between single and multiport procedures in patients who underwent laparoscopic surgery during pregnancy between 2017 and 2021.
Fifty-four pregnant patients were included: 26 who underwent LESS (salpingectomy, 11 cases/cystectomy, 15 cases) and 28 who underwent conventional laparoscopic surgeries (salpingectomy, 12 cases/cystectomy, 16 cases) during pregnancy. One patient in the single-port group required additional ports. No patients converted to laparotomy. In patients undergoing salpingectomy, the single-port group showed lower 8- and 24-h postoperative pain scores, shorter hospital stays, and lower Self-rating Anxiety Scale scores prior to discharge versus conventional laparoscopy. One patient experienced postoperative vaginal bleeding and a missed abortion during follow-up. In patients receiving cystectomy, 8- and 24-h pain scores, postoperative hospital stay, and anxiety scores were lower in the single-port versus multiport group. Other outcomes were comparable between the groups.
The feasibility and efficacy of laparoscopic surgery during pregnancy is similar between single- or multiport routes, however, the single-port route may be associated with less postoperative pain, shorter hospital stay, and lower anxiety.
评估腹腔镜单部位手术（LESS）在妊娠急腹症患者中的安全性和可行性。
回顾性比较 2017 年至 2021 年期间行腹腔镜手术的妊娠患者中单部位和多部位手术的基线特征、手术结果以及产科和新生儿结局。
共纳入 54 例妊娠患者：26 例行 LESS（输卵管切除术 11 例/囊肿切除术 15 例），28 例行传统腹腔镜手术（输卵管切除术 12 例/囊肿切除术 16 例）。单端口组有 1 例患者需要额外的端口。无一例患者转为开腹手术。在输卵管切除术患者中，单端口组术后 8 小时和 24 小时的疼痛评分较低，住院时间较短，出院前的自评焦虑量表评分较低，与传统腹腔镜相比。1 例患者在随访中出现术后阴道出血和稽留流产。在接受囊肿切除术的患者中，单端口组术后 8 小时和 24 小时的疼痛评分、术后住院时间和焦虑评分均低于多端口组。其他结果两组间无差异。
在妊娠期间，腹腔镜手术的可行性和疗效在单部位或多部位途径之间相似，但单部位途径可能与术后疼痛减轻、住院时间缩短和焦虑降低有关。
