摘要
目的:比较袋内一体化电动旋切与袋内手动冷刀旋切在经脐单孔腹腔镜子宫肌瘤剔除术中的应用效果。方法:回顾性分析2021年7月至2023年6月期间在武汉大学中南医院妇科行经脐单孔腹腔镜子宫肌瘤剔除术患者的病历信息，包括袋内一体化电动旋切组52例，袋内手动冷刀旋切组61例。分析比较两组患者住院时长、手术时间、术中出血量、术中输血率、术后并发症发生率、术后24 h视觉模拟评分法(visual analogue scale，VAS)疼痛评分、取物袋破损率、术后引流管拔除时间、术后尿管拔除时间、术后肠道通气时间、术前与术后(1 d和3 d)血红蛋白差值及术后病理。结果:与袋内手动冷刀旋切组相比，袋内一体化电动旋切组手术时间更短[(152.88±43.37)min vs. (176.23±59.45)min，P＝0.021]、取物袋破损率更低[0(0.0%) vs. 8(13.1%)，P＝0.019]差异存在统计学意义(P<0.05)。住院时长、术中出血量、术中输血率、术后并发症发生率、术后24 h VAS疼痛评分、术后引流管拔除时间、术后尿管拔除时间、术后肠道通气时间、术前与术后(1 d和3 d)血红蛋白差值及术后病理，两组差异无统计学意义(P>0.05)。结论:在经脐单孔腹腔镜子宫肌瘤剔除术中，袋内一体化电动旋切是一种安全可行的方案，可与单孔腹腔镜及电动旋切器配套使用，与袋内手动冷刀旋切相比手术时长更短、取物袋破损率更低，但仍需大样本前瞻性研究进一步验证。
Abstract
Objective:To compare the application of in-bag integrated power morcellation and contained manual scalpel morcellation in transumbilical single-port laparoscopic myomectomy.Methods:The medical records of patients who underwent transumbilical single-port laparoscopic myomectomy at the Department of Gynecology, Zhongnan Hospital of Wuhan University from Jul. 2021 to Jun. 2023 were retrospectively analyzed. There were 52 patients who underwent in-bag integrated power morcellation and 61 patients who underwent contained manual scalpel morcellation. Compare and analyze the hospitalization time, operation time, intraoperative blood loss, intraoperative blood transfusion rate, postoperative complications, visual analogue scale (VAS) pain score of 24 h after surgery, the rate of bag breakage, postoperative drainage tube removal time, postoperative urinary catheter removal time, postoperative intestinal ventilation time, hemoglobin difference between preoperative and postoperative (1 d and 3 d) and postoperative pathology.Results:Compared with the contained manual scalpel morcellation group, the in-bag integrated power morcellation group had shorter operation time [(152.88±43.37)min vs. (176.23±59.45)min, P=0.021] and lower rate of bag breakage [0 (0.0%) vs. 8 (13.1%), P=0.019]. The difference was statistically significant (P<0.05). Compared the in-bag integrated power morcellation group with the contained manual scalpel morcellation group, there was no significantly statistical difference (P>0.05) in the hospitalization time, intraoperative blood loss, intraoperative blood transfusion rate, postoperative complications rate, VAS pain score of 24 h after surgery, postoperative drainage tube removal time, postoperative catheter removal time, postoperative intestinal ventilation time, hemoglobin difference between preoperative and postoperative (1 d and 3 d), and postoperative pathology.Conclusion:In transumbilical single-port laparoscopic myomectomy, in-bag integrated power morcellation is a safe and feasible solution. It can be used with single-port laparoscope and electric rotator. Compared with contained manual scalpel morcellation, in-bag integrated power morcellation has shorter operation time and lower bag breakage rate, but it still needs further verification in large-sample prospective studies.
基金项目
湖北省科技计划重大科技专项(2023BCA002)
中央高校基本科研业务费专项资金(2042022kf1157)
万方数据