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筷子技术与LESS 子宫切除术(CCLEH 研究)中的交叉技术:一项前瞻性随机对照试验。

Chopstick technique versus cross technique in LESS hysterectomy (CCLEH study): a prospective randomized controlled trial.

机构信息

Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University, No. 30, Gaotanyan Street, Shapingba District, Chongqing, 400038, China.

出版信息

Trials. 2022 Aug 20;23(1):702. doi: 10.1186/s13063-022-06650-w.

Abstract

BACKGROUND

The traditional cross technique can be used to complete most laparoendoscopic single-site surgery (LESS) procedures, but some relatively precise operations, such as vaginal stump suturing, are challenging. In practice, we have introduced a novel technique named the chopstick technique and applied it to more complex operations, such as cervical cancer operations, and found that it contributes to performing delicate surgery. The efficacy and safety of two different surgical techniques in LESS hysterectomy remain to be validated.

METHODS

Patients who undergo total hysterectomy will be enrolled in this RCT. Stratified randomization will be performed according to uterine size (< 10 cm, 10-15cm, ≥ 15 cm). The participants will be divided into the chopstick technique group or cross technique group to undergo laparoendoscopic single-site total hysterectomy (LESS-TH), and then the perioperative and postoperative data, including the total operation time and other times, transfer rates, estimated blood loss, surgeon fatigue, intraoperative and postoperative complications (within 8 weeks after surgery), health-related quality of life (EQ-5D) scores, postoperative hospital stay, and hospitalization expenses, will be evaluated. The primary outcome is the operating time for total hysterectomy under LESS, and the other outcomes are secondary outcomes.

DISCUSSION

It is expected that the efficacy of the two techniques in LESS, the chopstick technique vs. the cross technique, will be compared and accumulate safety data on the new techniques will be accumulated.

TRIAL REGISTRATION

ChiCTR2000040843, registered on June 16,2020 Protocol version: Version 2.0; Date: 2020.05.10.

摘要

背景

传统的交叉技术可用于完成大多数经腹腔镜单部位手术(LESS)操作,但一些相对精细的操作,如阴道残端缝合,具有挑战性。在实践中,我们引入了一种新的技术,称为筷子技术,并将其应用于更复杂的操作,如宫颈癌手术,发现它有助于进行精细的手术。两种不同的手术技术在 LESS 子宫切除术中的疗效和安全性仍有待验证。

方法

本 RCT 将纳入接受全子宫切除术的患者。将根据子宫大小(<10cm、10-15cm、≥15cm)进行分层随机分组。参与者将分为筷子技术组或交叉技术组,进行经腹腔镜单部位全子宫切除术(LESS-TH),然后评估围手术期和术后数据,包括总手术时间和其他时间、中转率、估计出血量、术者疲劳、术中及术后并发症(术后 8 周内)、健康相关生活质量(EQ-5D)评分、术后住院时间和住院费用。主要结局是 LESS 下全子宫切除术的手术时间,其他结局为次要结局。

讨论

预计将比较两种技术在 LESS 中的疗效,即筷子技术与交叉技术,并积累新技术的安全性数据。

试验注册

ChiCTR2000040843,于 2020 年 6 月 16 日注册 方案版本:版本 2.0;日期:2020.05.10.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8f8/9392233/6a72f7a415a1/13063_2022_6650_Fig1_HTML.jpg

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