Application value of transumbilical single-port laparoscopy in treating benign adnexal tumors of middle-aged and elderly women
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摘要:目的 探讨经脐单孔腹腔镜技术在中老年女性附件良性肿瘤手术中的应用价值。方法 选取附件良性肿瘤患者37例，随机分为实验组(经脐单孔腹腔镜)17例与对照组(多孔腹腔镜)20例。比较2组患者术中和术后的临床结局。结果 2组手术均获成功，无1例中转开腹。2组手术时间、术中出血量、术后排气时间、住院时间均无显著差异(P>0.05)。与对照组比较，实验组术后疼痛评分较低，满意度较高，差异有统计学意义(P < 0.05)。2组患者术后病理结果均为良性肿瘤，与术前诊断相符。所有患者均随访1~3个月，切口愈合满意，无感染、延迟愈合、静脉血栓、腹腔内出血、皮下血肿、切口疝等术后并发症发生。结论 经脐单孔腹腔镜技术治疗中老年女性附件良性肿瘤安全、有效，具有疼痛轻、切开小等优点。Abstract:Objective To investigate the application value of transumbilical single-port laparoscopy in the operation of benign adnexal tumors in middle-aged and elderly women.Methods Totally 37 patients with benign adnexal tumors were randomly divided into experimental group (transumbilical laparoscopy) with 17 cases and control group (porous laparoscopy) with 20 cases. The clinical outcomes during and after operation were compared between the two groups.Results The operations were successful in both groups, and none of them was converted to open surgery. There were no significant differences in operation time, intra-operative bleeding volume, postoperative exhaust time and hospitalization time between the two groups (P>0.05). Compared with the control group, the pain score of the experimental group was lighter and the satisfaction degree was higher, and there were significant differences (P < 0.05). Postoperative pathologic result was benign tumors in both groups, which was consistent with preoperative diagnosis. All patients were followed up for 1 to 3 months. The wound healing was satisfactory. No complications such as infection, delayed healing, venous thrombosis, intraperitoneal hemorrhage, subcutaneous hematoma and incisional hernia occurred were observed.Conclusion Transumbilical single-port laparoscopy is safe and effective in the treatment of benign adnexal tumors in middle-aged and elderly women, with advantages of light pain and small incision.
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表 1 2组患者术前临床资料比较
组别 n 年龄/岁 体质量指数/(kg/m2) 孕史/次 产史/次 实验组 17 58.70(4.17) 32.57(3.10) 2.00(1.00) 1(0.00) 对照组 20 59.50(5.25) 31.46(4.95) 2.00(2.00) 1(0.00) 临床资料以中位数(四分位数间距)表示。 
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表 2 2组患者术前血清肿瘤标志物水平比较
组别 n HE4/(pmol/L) CA125/(U/mL) AFP/(ng/mL) CEA/(ng/mL) CA-199/(U/mL) 实验组 17 38.24(3.12) 27.53(2.14) 2.13(1.73) 1.87(2.13) 18.26(3.15) 对照组 20 39.37(5.31) 27.06(3.57) 1.92(2.16) 2.11(1.19) 17.83(2.73) 血清肿瘤标志物水平以中位数(四分位数间距)表示。
HE4: 人附睾蛋白; CA125: 糖类抗原125; AFP: 甲胎蛋白; CEA: 癌胚抗原; CA-199: 糖类抗原199。
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表 3 2组患者术中及术后临床结局指标比较
组别 手术时间/min 术中出血量/mL 术后排气时间/h 住院时间/d 疼痛评分/分 满意度/分 实验组 46.00(6.00) 3.00(3.00) 14.00(3.00) 3.00(1.00) 2.00(1.00)* 5.00(1.00)* 对照组 44.00(9.00) 3.00(1.50) 14.00(1.25) 3.00(0.25) 4.50(1.00) 3.00(0.00) 临床结局指标以中位数(四分位数间距)表示。与对照组比较, *P < 0.05。
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