linical analysis of 16 cases of large benign adnexal mass treated by transumbilical laparoendosopic single-site surgery
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摘要:
目的 探讨自制入路通道的经脐单孔腹腔镜手术在治疗女性附件巨大良性包块中的临床应用价值。 方法 收集克拉玛依市中心医院妇科自2017年2月—2019年9月成功开展的经脐单孔腹腔镜下16例附件巨大良性包块手术，术中均使用自制的入路通道及常规的腹腔镜器械，包块最大径线为12~35 cm，其中成熟性畸胎瘤6例，卵巢良性浆液性肿瘤4例，卵巢良性黏液性肿瘤2例，单纯性卵巢囊肿2例，输卵管系膜囊肿1例，输卵管积水1例。患者平均年龄(41.9±19.1)岁，平均体重指数为22.0±3.2。既往有盆腹腔手术史4例，术中盆腹腔粘连6例，均无致密的肠粘连。 结果 16例患者中包块最大直径平均(18.0±6.1)cm，平均手术时间(47.6±13.0)min，术中出血量为(17.4±11.1)mL，术后首次排气时间为(7.4 ±2.2)h，术后首次下床活动时间为(6.2±0.7)h，术后24 h VAS评分为(0.9±0.4)分，术后住院天数为(2.2±0.4)d，16例术中均未出现并发症，术后随访3~6个月, 脐部切口愈合好，患者满意度高。 结论 自制入路通道的经脐单孔腹腔镜手术适合附件巨大良性包块，能充分体现出经脐单孔腹腔镜手术的优势，值得在临床中推广。 Abstract:Objective To explore the clinical effect of transumbilical laparoendosopic single-site surgery with self-made approach in the treatment of large adnexal begin mass. Methods Total 16 cases of large adnexal begin mass operation with transumbilical laparoendosopic single-site were successfully carried out by Gynecological Department of Central Hospital in Karamay City from February 2017 to September 2019. All cases were performed with homemade approach and conventional laparoscopic instruments. The maximum diameter of the mass ranged from 12 to 35 cm, including 6 mature teratomas, 4 benign ovarian serous tumors, 2 benign ovarian mucinous tumor, 2 simple ovarian cysts, 1 mesosalpinx cyst and 1 hydrosalpinx. The mean age of the patients was (41.9±19.1) years, and the mean body mass index (BMI) was (22.0±3.2). There were 4 cases of pelvic and abdominal cavity operation history and 6 cases of pelvic and abdominal cavity adhesion, but no dense intestinal adhesion was found in all patients. Results The average diameter of the mass was (18.0±6.1) cm, the average operation time was (47.6±13.0) min, the intraoperative blood loss was (17.4±11.1) mL, the first postoperative exhaust time was (7.4±2.2) h, the first postoperative ambulation time was (6.2±0.7) h, the pain visual analogue scale (VAS) was (0.9±0.4) min, and the postoperative hospital stay was (2.2±0.4) d. There were no complications in 16 cases and after surgery. Follow-up of 3 to 6 months, the umbilical incision healed well and the patient's satisfaction was high. Conclusion The transumbilical laparoendosopic single-site surgery with self-made approach is suitable for the operation of large adnexal begin mass. It can fully reflect the advantages of transumbilical laparoendosopic single-site surgery, which is worth popularizing in clinical practice. -
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