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基于腹膜后盆腔间隙解剖的腹腔镜单部位手术治疗深部浸润性子宫内膜异位症:一项回顾性研究。

Laparoendoscopic single-site surgery for deep infiltrating endometriosis based on retroperitoneal pelvic spaces anatomy: a retrospective study.

机构信息

Dalian Medical University, Dalian, 116000, People's Republic of China.

Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China.

出版信息

Sci Rep. 2023 Jul 4;13(1):10785. doi: 10.1038/s41598-023-38034-8.

DOI:10.1038/s41598-023-38034-8
PMID:37402839
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10319708/
Abstract

Transumbilical single-port laparoscopy is widely used in gynecological surgery. However, it is rarely used in the treatment of deep infiltrating endometriosis due to its own shortcomings and the complex condition of deep infiltrating endometriosis. The study aims to introduce a transumbilical single-port laparoscopic surgery based on retroperitoneal pelvic spaces anatomy, which can complete the operation of deep infiltrating endometriosis more easily. A retrospective analysis of 63 patients with deep infiltrating endometriosis treated by transumbilical single-port laparoscopy using this method was conducted. The operation duration was 120.00 (85.00 ± 170.00) (35-405) min, the estimated blood loss was 68.41 ± 39.35 ml, the postoperative hospital stay was 5.00 (4.00-6.00) days, and the incidence of postoperative complications was 4.76% (3/63). 1 patient was found to have intestinal injury during operation, 1 patient had ureteral injury after operation, and 1 patient had postoperative pelvic infection, with a recurrence rate of 9.52%. The postoperative scar score was 3.00 (3.00-4.00) and the postoperative satisfaction score was 9.00 (8.00-10.00). In summary, this study demonstrates the feasibility of transumbilical single-port laparoscopic surgery for deep infiltrating endometriosis based on retroperitoneal pelvic spaces anatomy. Hysterectomy, adenomyosis resection, etc. are also feasible with this method, boasting more obvious advantages. This method can make transumbilical single-port laparoscopy more widely used in deep infiltrating endometriosis.

摘要

经脐单孔腹腔镜广泛应用于妇科手术,但由于其自身的局限性和深部浸润型子宫内膜异位症的复杂性,在深部浸润型子宫内膜异位症的治疗中应用较少。本研究旨在介绍一种基于腹膜后盆腔间隙解剖的经脐单孔腹腔镜手术,以更轻松地完成深部浸润型子宫内膜异位症的手术操作。回顾性分析了采用该方法行经脐单孔腹腔镜手术治疗的 63 例深部浸润型子宫内膜异位症患者的临床资料。手术时间为 120.00(85.00±170.00)(35-405)min,估计出血量为 68.41±39.35ml,术后住院时间为 5.00(4.00-6.00)d,术后并发症发生率为 4.76%(3/63)。术中发现 1 例肠损伤,术后 1 例输尿管损伤,1 例术后盆腔感染,复发率为 9.52%。术后瘢痕评分 3.00(3.00-4.00),术后满意度评分 9.00(8.00-10.00)。综上所述,本研究表明基于腹膜后盆腔间隙解剖的经脐单孔腹腔镜手术治疗深部浸润型子宫内膜异位症是可行的,该方法还可行子宫切除术、子宫腺肌病切除术等,具有更明显的优势。该方法可使经脐单孔腹腔镜在深部浸润型子宫内膜异位症中的应用更为广泛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034c/10319708/9db9ab6a41ca/41598_2023_38034_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034c/10319708/7bec940c168a/41598_2023_38034_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034c/10319708/5b5a291a75c4/41598_2023_38034_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034c/10319708/9db9ab6a41ca/41598_2023_38034_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034c/10319708/7bec940c168a/41598_2023_38034_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034c/10319708/5b5a291a75c4/41598_2023_38034_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/034c/10319708/9db9ab6a41ca/41598_2023_38034_Fig3_HTML.jpg

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