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腹腔镜单孔子宫肌瘤切除术与传统腹腔镜子宫肌瘤切除术隐匿性失血的比较

Comparison of Hidden Blood Loss between Laparoendoscopic Single-Site Myomectomy and Conventional Laparoscopic Myomectomy.

作者信息

Tao Jiayu, Zhu Sennan, Chen Ziqi, Chen Qiuyu, Du Wenzhuo, Sun Jindan, Yu Mengqi, Zhou Yi, Zhao Yu, Zhang Qiong

机构信息

Department of Obstetrics and Gynaecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

The Second School of Medicine, Wenzhou Medical University, Wenzhou, China.

出版信息

Gynecol Obstet Invest. 2025;90(1):55-63. doi: 10.1159/000539898. Epub 2024 Sep 25.

Abstract

OBJECTIVE

Laparoendoscopic single-site myomectomy (LESS-M) is widely applied for the treatment of uterine leiomyoma. The purposes of this study were to investigate differences in hidden blood loss between LESS-M and conventional laparoscopic myomectomy (CLM) during treatment of uterine leiomyoma and to identify the associated risk factors.

DESIGN

This is a retrospective study.

PARTICIPANTS

The participants of this study were patients who underwent laparoscopic myomectomy (114 and 156 for LESS-M and CLM, respectively) between July 1, 2019, and October 10, 2020, at the Second Affiliated Hospital of Wenzhou Medical University.

SETTING

The study was conducted at the Second Affiliated Hospital of Wenzhou Medical University.

METHODS

We enrolled a total of 114 and 156 patients who were treated with LESS-M and CLM, respectively, between July 1, 2019, and October 10, 2020. We collected clinical data, then applied the Nadler and Gross formula and multiple linear regression analysis to calculate the HBL and identify the associated risk factors, respectively.

RESULTS

Patients in the LESS-M group had a VBL of 115.4 ± 180.6 mL and an HBL of 364.3 ± 252.6 mL, accounting for 74.4 ± 22.4% of true TBL. On the other hand, patients in the CLM group had VBL of 187.9 ± 198.5 mL, and HBL of 306.8 ± 304.7 mL, accounting for 58.9 ± 30.2% of true TBL. HBL was significantly higher in the LESS-M than the CLM group (p = 0.000).

LIMITATIONS

This study was the small sample size used.

CONCLUSIONS

HBL accounted for a significant percentage of TBL in laparoscopic myomectomy, especially in patients treated with LESS-M. Paying attention to perioperative blood changes coupled with fully understanding HBL might promote postoperative recovery of patients.

摘要

目的

腹腔镜单孔子宫肌瘤切除术(LESS-M)已广泛应用于子宫肌瘤的治疗。本研究旨在探讨LESS-M与传统腹腔镜子宫肌瘤切除术(CLM)治疗子宫肌瘤时隐性失血的差异,并确定相关危险因素。

设计

这是一项回顾性研究。

参与者

本研究的参与者为2019年7月1日至2020年10月10日期间在温州医科大学附属第二医院接受腹腔镜子宫肌瘤切除术的患者(LESS-M组114例,CLM组156例)。

地点

研究在温州医科大学附属第二医院进行。

方法

我们纳入了2019年7月1日至2020年10月10日期间分别接受LESS-M和CLM治疗的114例和156例患者。我们收集了临床数据,然后应用Nadler和Gross公式以及多元线性回归分析分别计算隐性失血并确定相关危险因素。

结果

LESS-M组患者的显性失血为115.4±180.6 mL,隐性失血为364.3±252.6 mL,占总失血量的74.4±22.4%。另一方面,CLM组患者的显性失血为187.9±198.5 mL,隐性失血为306.8±304.7 mL,占总失血量的58.9±30.2%。LESS-M组的隐性失血显著高于CLM组(p = 0.000)。

局限性

本研究样本量较小。

结论

在腹腔镜子宫肌瘤切除术中,隐性失血占总失血量的比例较大,尤其是在接受LESS-M治疗的患者中。关注围手术期血液变化并充分了解隐性失血可能促进患者术后恢复。

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