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子宫肌瘤治疗中单孔腹腔镜手术的回顾性分析

A retrospective analysis of single-port laparoscopy in myoma management.

作者信息

Li Hanqin, You Wei, Cai Xiaoji, Jin Xiaoying, Che Xuan

机构信息

Department of Obstetrics and Gynecology, Jiaxing University Affiliated Women and Children Hospital, Jiaxing, 314000, Zhejiang, China.

出版信息

Heliyon. 2024 Aug 5;10(15):e35821. doi: 10.1016/j.heliyon.2024.e35821. eCollection 2024 Aug 15.

Abstract

OBJECTIVE

This study assesses the effectiveness and safety of single-port laparoscopic myomectomy (SPLM) versus conventional laparoscopic myomectomy (CLM).

METHODS

We conducted a retrospective case-control study at a university tertiary hospital, involving 262 patients treated from July 2020 to December 2022. Participants were divided into two groups: 132 underwent SPLM and 130 underwent CLM.

RESULTS

The two groups were comparable in terms of age, body mass index, parity, delivery history, preoperative anemia, number of myomas, and size of the largest myoma. The SPLM group showed a significant reduction in operation time (average 93 min) and estimated blood loss (average 50 ml) compared to the CLM group (average 118.5 min and 100 ml, respectively). Subgroup analysis based on the size, location, and number of myomas further highlighted the advantages of SPLM, particularly for patients with large (diameter ≥8 cm) or multiple myomas (number ≥4). Patient satisfaction was also notably higher in the SPLM group.

CONCLUSIONS

Single-port laparoscopic myomectomy offers a highly effective, safer, and patient-preferred option for the surgical management of fibroids, especially in cases of large or multiple myomas. These findings suggest that SPLM could become the preferred surgical approach for complex fibroid cases, promising less trauma and quicker recovery for patients.

摘要

目的

本研究评估单孔腹腔镜子宫肌瘤切除术(SPLM)与传统腹腔镜子宫肌瘤切除术(CLM)的有效性和安全性。

方法

我们在一家大学三级医院进行了一项回顾性病例对照研究,纳入了2020年7月至2022年12月期间接受治疗的262例患者。参与者分为两组:132例行SPLM,130例行CLM。

结果

两组在年龄、体重指数、产次、分娩史、术前贫血、肌瘤数量和最大肌瘤大小方面具有可比性。与CLM组(平均分别为118.5分钟和100毫升)相比,SPLM组的手术时间(平均93分钟)和估计失血量(平均50毫升)显著减少。基于肌瘤大小、位置和数量的亚组分析进一步突出了SPLM的优势,特别是对于大肌瘤(直径≥8厘米)或多发肌瘤(数量≥4个)的患者。SPLM组的患者满意度也显著更高。

结论

单孔腹腔镜子宫肌瘤切除术为子宫肌瘤的手术治疗提供了一种高效、更安全且患者更青睐的选择,尤其是在大肌瘤或多发肌瘤的情况下。这些发现表明,SPLM可能成为复杂肌瘤病例的首选手术方法,有望减少患者创伤并加快康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/282d/11337055/64f0cc591f4f/gr1.jpg

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