经阴道自然腔道内镜手术辅助腹腔镜下全子宫切除术的临床研究

发布时间：2018-06-28 20:03

本文选题：自然腔道内镜手术 + 腹腔镜手术　；参考：《现代妇产科进展》2017年10期

【摘要】：目的:探讨经阴道自然腔道内镜(NOTES)手术辅助腹腔镜下全子宫切除术的可行性及效果。方法:选取2016年10月至11月在复旦大学附属妇产科医院行NOTES辅助腹腔镜下全子宫切除术的10例非脱垂子宫良性疾病患者和行腹腔镜辅助阴式全子宫切除术(LAVH)的20例患者。比较两组患者的术中出血量、输血情况、手术时间、拔尿管时间、术后VAS评分及术后住院时间。结果:30例患者均完成相应的手术操作,无中转开腹/经腹腹腔镜手术,无术中、术后并发症,无输血病例。NOTES组患者的术后12h VAS评分显著小于LAVH组[(2.2±0.5)分vs(3.8±1.5)分,P=0.003],术后拔除尿管时间显著小于LAVH组[(30.4±6.7)h vs(45.6±12.1)h,P0.001],术后住院天数显著小于LAVH组[(2.7±0.8)d vs(4.5±1.4)d,P0.001]。两组的手术时间、术中出血量比较,差异无统计学意义(P0.05)。结论:经阴道自然腔道内镜手术辅助腹腔镜下全子宫切除术可行、简便、安全、有效,较腹腔镜辅助阴式全子宫切除术更加微创。
[Abstract]:Objective: to investigate the feasibility and effect of transvaginal endoscopy (NOTES) assisted laparoscopic hysterectomy. Methods: from October to November 2016, 10 patients with non-prolapse benign uterine diseases and 20 patients with laparoscopic assisted vaginal hysterectomy (LAVH) were selected from the Department of Obstetrics and Gynecology of Fudan University. The blood loss, blood transfusion, operation time, urinary catheter extraction time, postoperative VAS score and postoperative hospitalization time were compared between the two groups. Results all the 30 patients underwent the operation, no conversion to open / transabdominal laparoscopy, no intraoperative and postoperative complications, The scores of VAS in patients without transfusion. NOTES group were significantly lower than those in LAVH group [(2.2 卤0.5) vs (3.8 卤1.5) min P0. 003], the time of extubation was significantly shorter than that in LAVH group [(30.4 卤6.7) h vs (45.6 卤12.1) HP0.001], and the postoperative hospitalization days were significantly lower than that in LAVH group [(2.7 卤0.8) d vs (4.5 卤1.4) dP0.001]. There was no significant difference in operative time and intraoperative bleeding between the two groups (P0.05). Conclusion: transvaginal endoscopy assisted laparoscopic hysterectomy is feasible, simple, safe and effective, and is more minimally invasive than laparoscopic assisted vaginal hysterectomy.
【作者单位】：复旦大学附属妇产科医院;
【分类号】：R713.42

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