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单孔与多孔全腹腔镜子宫切除术在单中心的长期经验。

Long-term Experience of Single-port and Multi-port Total Laparoscopic Hysterectomy in a Single Center.

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.

Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

出版信息

In Vivo. 2022 Sep-Oct;36(5):2409-2413. doi: 10.21873/invivo.12974.

DOI:10.21873/invivo.12974
PMID:36099098
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9463880/
Abstract

BACKGROUND/AIM: Short-term feasibility and safety of single-port total laparoscopic hysterectomy (TLH) compared with conventional multi-port TLH have been previously demonstrated. However, recent studies are insufficient. This study aimed to analyze long-term data from our center to examine the current status of single-port and multi-port TLH. PATIENTS AND METHODS: In 766 patients who received TLH from 2005 to 2019, 325 were single-port and 441 were multi-port. Inclusion criteria were benign and premalignant uterine diseases. To reduce the impact of treatment selection bias and potential confounding factors, inverse probability of treatment weighting was applied. RESULTS: Single-port TLH showed significantly better clinical outcomes for hospital stay, operative time, hemoglobin decrease, and complication rate than the multi-port TLH after correction of biases. C-reactive protein increased after the single-port TLH. CONCLUSION: As laparoscopic surgical instruments and surgeon's skill have been improved, some surgical outcomes have become significantly better in single-port TLH after long-term observation.

摘要

背景/目的：与传统多孔腹腔镜子宫切除术（TLH）相比，单孔 TLH 的短期可行性和安全性已得到证实。然而，最近的研究还不够充分。本研究旨在分析我们中心的长期数据，以检查单孔和多孔 TLH 的现状。

患者和方法：在 2005 年至 2019 年间接受 TLH 的 766 名患者中，325 名接受了单孔 TLH，441 名接受了多孔 TLH。纳入标准为良性和癌前子宫疾病。为了减少治疗选择偏差和潜在混杂因素的影响，应用了逆概率治疗加权。

结果：经偏差校正后，单孔 TLH 在住院时间、手术时间、血红蛋白下降和并发症发生率方面的临床结局明显优于多孔 TLH。单孔 TLH 后 C 反应蛋白升高。

结论：随着腹腔镜手术器械和外科医生技能的提高，经过长期观察，单孔 TLH 的一些手术结果显著改善。

相似文献

[1]
Long-term Experience of Single-port and Multi-port Total Laparoscopic Hysterectomy in a Single Center.

In Vivo. 2022

[2]
Abdominal, multi-port and single-port total laparoscopic hysterectomy: eleven-year trends comparison of surgical outcomes complications of 936 cases.

Arch Gynecol Obstet. 2015-6

[3]
Operative outcomes of single-port-access laparoscopy-assisted vaginal hysterectomy compared with single-port-access total laparoscopic hysterectomy.

Taiwan J Obstet Gynecol. 2014-12

[4]
A comparison of postoperative pain after transumbilical single-port access and conventional three-port total laparoscopic hysterectomy: a randomized controlled trial.

Acta Obstet Gynecol Scand. 2015-12

[5]
Overcoming the learning curve of single-port total laparoscopic hysterectomy with barbed suture: a single surgeon's initial experience.

Wideochir Inne Tech Maloinwazyjne. 2017-9

[6]
Laparoscopic supracervical hysterectomy (LSH) versus total laparoscopic hysterectomy (TLH): an implementation study in 1,952 patients with an analysis of risk factors for conversion to laparotomy and complications, and of procedure-specific re-operations.

Arch Gynecol Obstet. 2013-6-18

[7]
Single-port access total laparoscopic hysterectomy with Korean-made OCTO Port: Turkish surgeons' initial experience.

J Obstet Gynaecol. 2016

[8]
Transumbilical single-port access versus conventional total laparoscopic hysterectomy: surgical outcomes.

Am J Obstet Gynecol. 2010-4-24

[9]
Comparison of surgical outcomes between robot-assisted laparoscopic hysterectomy and conventional total laparoscopic hysterectomy in gynecologic benign disease: a single-center cohort study.

J Robot Surg. 2023-10

[10]
Feasibility and Surgical Outcomes of Hybrid Robotic Single-Site Hysterectomy Compared with Single-Port Access Total Laparoscopic Hysterectomy.

J Pers Med. 2023-7-24

引用本文的文献

[1]
Comparison of barbed suture and conventional suture in laparoendoscopic single-site myomectomy.

Front Oncol. 2025-5-1

[2]
Postoperative abdominopelvic adhesion and umbilical wound validation after single-port laparoscopy or two-port laparoscopy for gynecological surgery: a comparison with conventional laparoscopy.

Arch Gynecol Obstet. 2025-6

本文引用的文献

[1]
Comparison of laparoendoscopic single-site (LESS) surgery and conventional multiport laparoscopic (CMPL) surgery for hysterectomy: long-term outcomes of abdominal incisional scar.

J Obstet Gynaecol. 2020-2

[2]
Laparoendoscopic single-site surgery versus conventional laparoscopy for hysterectomy: a systematic review and meta-analysis.

Arch Gynecol Obstet. 2017-5

[3]
Single-Port vs Multiport Laparoscopic Hysterectomy: A Meta-Analysis of Randomized Controlled Trials.

J Minim Invasive Gynecol. 2016

[4]
Review and meta-analysis of prospective randomized controlled trials (RCTs) comparing laparo-endoscopic single site and multiport laparoscopy in gynecologic operative procedures.

Arch Gynecol Obstet. 2016-9

[5]
Total vaginal and single-port total laparoscopic hysterectomy for uterine benign diseases.

Minim Invasive Ther Allied Technol. 2016

[6]
Systematic review and meta-analysis of single-port versus conventional laparoscopic hysterectomy.

Int J Gynaecol Obstet. 2016-4

[7]
Statistical power in parallel group point exposure studies with time-to-event outcomes: an empirical comparison of the performance of randomized controlled trials and the inverse probability of treatment weighting (IPTW) approach.

BMC Med Res Methodol. 2015-10-15

[8]
Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies.

Stat Med. 2015-12-10

[9]
Robotic hysterectomy or myomectomy without power morcellation: A single-port assisted three-incision technique with manual morcellation.

Int J Med Robot. 2016-9

[10]
YS knot: A new technique for a tension-controlled slip knot using a trocar.

Obstet Gynecol Sci. 2015-3

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