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经脐腹腔镜单孔手术在妇科肿瘤加速康复外科实施中的作用:一项回顾性研究

Role of transumbilical laparoendoscopic single-site surgery in the implementation ERAS in gynecology oncology: a retrospective study.

作者信息

Li Fanlin, Zheng Ying, Chen Sijing, Wang Qiao, Wang Kana, Yang Fan, Liu Jianhong, Wang Na

机构信息

Department of Gynecologic Oncology, West China Second Hospital, Sichuan University, and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.

Department of Ambulatory Surgery Center, West China Second Hospital, Sichuan University, and Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.

出版信息

Front Oncol. 2025 Apr 22;15:1483878. doi: 10.3389/fonc.2025.1483878. eCollection 2025.

Abstract

OBJECTIVE

The aim of the study was to verify the fast recovery effect of transumbilical laparoendoscopic single-site surgery by analyzing the operative and postoperative outcomes of patients with various gynecological malignancies in implementing The Enhanced Recovery After Surgery (ERAS) protocols.

DESIGN

A retrospective study.

SETTING

A university academic hospital.

POPULATION OR SAMPLE

Patients with cervical, endometrial or ovarian cancer undergoing transumbilical laparoendoscopic single-site surgery by a single experienced surgeon.

METHODS

This was a retrospective consecutive single-center study of patients with cervical, endometrial, or ovarian cancer undergoing transumbilical laparoendoscopic single-site surgery for full surgical staging from November 2017 to January 2022.

MAIN OUTCOME MEASURES

The main outcomes were the perioperative outcomes in various surgeries, including surgery time, estimated blood loss, length of hospital stay, and complications.

RESULTS

315 gynecologic malignant cases successfully experienced transumbilical laparoendoscopic single-site surgery (TU-LESS) between November 2017 and January 2022 in West China Second Hospital were incorporated, including 195 cervical cancers, 85 endometrial cancers and 35 ovarian cancers. The average age for patients is 47.48 (SD = 8.77). 152 (48.25%) patients have a history of previous pelvic and abdominal surgery. The average operating time and blood loss are 273.71 (SD = 87.12) minutes and 166.87 (SD = 237.09) ml, respectively. The average time for the first passage of flatus is 43.68 (SD = 29.75) hours. The hospitalization is 5.30 (SD = 2.42) days on average.

CONCLUSIONS

TU-LESS can enhance the recovery of patients who suffer from gynecological malignancies by implementing ERAS with fast flatus, less pain, shorter hospitalization and better rehabilitation.

摘要

目的

本研究旨在通过分析实施加速康复外科(ERAS)方案的各类妇科恶性肿瘤患者的手术及术后结果,验证经脐单孔腹腔镜手术的快速康复效果。

设计

一项回顾性研究。

地点

一所大学附属医院。

研究对象或样本

由同一位经验丰富的外科医生为患有宫颈癌、子宫内膜癌或卵巢癌的患者实施经脐单孔腹腔镜手术。

方法

这是一项对2017年11月至2022年1月期间因全面手术分期而接受经脐单孔腹腔镜手术的宫颈癌、子宫内膜癌或卵巢癌患者进行的回顾性连续单中心研究。

主要观察指标

主要观察指标为各类手术的围手术期结果,包括手术时间、估计失血量、住院时间和并发症。

结果

2017年11月至2022年1月期间,四川大学华西第二医院共有315例妇科恶性肿瘤患者成功接受了经脐单孔腹腔镜手术(TU-LESS),其中宫颈癌195例,子宫内膜癌85例,卵巢癌35例。患者的平均年龄为47.48岁(标准差=8.77)。152例(48.25%)患者既往有盆腔和腹部手术史。平均手术时间和失血量分别为273.71分钟(标准差=87.12)和166.87毫升(标准差=237.09)。首次排气的平均时间为43.68小时(标准差=29.75)。平均住院时间为5.30天(标准差=2.42)。

结论

经脐单孔腹腔镜手术通过实施ERAS方案,可实现快速排气、减轻疼痛、缩短住院时间和更好的康复效果,从而促进妇科恶性肿瘤患者的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd5b/12052559/cb2b7d3e069e/fonc-15-1483878-g001.jpg

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