Application effect of gasless single-port laparoscopy assisted with abdominal wall suspension in total hysterectomy and adnexectomy

XIONG Min; LU Bai-yu; LIU Xiao-fang; LUO Shuang; TANG Chen-dian

doi:10.11659/jjssx.09E022064

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Application effect of gasless single-port laparoscopy assisted with abdominal wall suspension in total hysterectomy and adnexectomy

Clinical Research | 更新时间：2023-06-13

- Application effect of gasless single-port laparoscopy assisted with abdominal wall suspension in total hysterectomy and adnexectomy
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 32, Issue 6, Pages: 511-515(2023)
- 作者机构：
  
  遂宁市中心医院妇科，四川遂宁 629000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.09E022064
  CLC： R713
- Published：25 June 2023，
  
  Received：13 September 2022，
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熊敏,卢白玉,刘晓芳等.免气腹悬吊式单孔腹腔镜在全子宫及附件切除术中的应用效果[J].局解手术学杂志,2023,32(06):511-515.

XIONG Min,LU Bai-yu,LIU Xiao-fang,et al.Application effect of gasless single-port laparoscopy assisted with abdominal wall suspension in total hysterectomy and adnexectomy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(06):511-515.
熊敏,卢白玉,刘晓芳等.免气腹悬吊式单孔腹腔镜在全子宫及附件切除术中的应用效果[J].局解手术学杂志,2023,32(06):511-515. DOI： 10.11659/jjssx.09E022064.

XIONG Min,LU Bai-yu,LIU Xiao-fang,et al.Application effect of gasless single-port laparoscopy assisted with abdominal wall suspension in total hysterectomy and adnexectomy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(06):511-515. DOI： 10.11659/jjssx.09E022064.

摘要

目的

观察免气腹悬吊式单孔腹腔镜在全子宫及附件切除术中的应用效果。

方法

选择我院收治的子宫及附件区病变患者共84例，按照手术方式将患者分为传统组（41例，传统腹腔镜全子宫及附件切除术）和免气腹组（43例，免气腹悬吊式单孔腹腔镜全子宫及附件切除术）。对比2组患者临床相关指标；监测2组患者麻醉前（T0）、麻醉后5 min（T1）、气腹或悬吊建立后10 min（T2）、气腹或悬吊建立后30 min（T3）、气腹或悬吊撤除后5 min（T4）的血氧饱和度（SpO

）、呼气末二氧化碳分压（PETCO

）、气道压力（Paw）、平均动脉压（MAP）、心率（HR）；记录2组患者并发症发生情况。

结果

免气腹组术后肠道功能恢复时间、住院时间短于传统组，住院费用少于传统组（

0.05）。T1~T4时点，传统组SpO

呈先下降后升高趋势（

0.05），免气腹组SpO

则无明显波动（

0.05）；免气腹组T1~T3时点SpO

均高于传统组（

0.05）。T2~T4时点，传统组PETCO

、Paw呈先升高后下降趋势（

0.05），免气腹组PETCO

、Paw则无明显波动（

0.05）；T2、T3时点，免气腹组PETCO

、Paw均低于传统组（

0.05）。T1~T4时点，2组患者MAP、HR均呈先升高后下降趋势（

0.05），且免气腹组MAP、HR均低于传统组（

0.05）。2组患者并发症发生率比较差异无统计学意义（

0.05）。

结论

与传统腹腔镜全子宫及附件切除术相比，免气腹悬吊式单孔腹腔镜全子宫及附件切除术可减轻患者手术损伤，同时还可改善呼吸循环功能，维持血流动力学稳定，有利于患者术后早期恢复。

Abstract

Objective

To observe the application effect of gasless single-port laparoscopy assisted with abdominal wall suspension in total hysterectomy and adnexectomy.

Methods

A total of 84 patients with uterine and adnexal lesions who were admitted to our hospital were selected. According to the surgical method， patients were divided into the traditional group （41 cases of traditional total laparoscopic hysterectomy and adnexectomy） and the non-pneumoperitoneum group （43 cases of gasless single-port total laparoscopic hysterectomy and adnexectomy assisted with abdominal wall suspension）. The clinical related indicators of patients in the two groups were compared.The levels of oxygen saturation （SpO

），partial pressure of end-tidal carbon dioxide （PETCO

）， airway pressure （Paw）， mean arterial pressure （MAP）， heart rate （HR） before anesthesia （T0）， 5 minutes after anesthesia （T1）， 10 minutes after the establishment of pneumoperitoneum or suspension （T2）， 30 minutes after the establishment of pneumoperitoneum or suspension （T3）， 5 minutes after the removal of pneumoperitoneum or suspension （T4）of the patients in the two groups were monitored. The incidence of complications of patients in the two groups were recorded.

Results

The postoperative recovery time of intestinal function and hospital stay in the non-pneumoperitoneum group were shorter than those in the traditional group， and the hospitalization cost was less than that in the traditional group （

0.05）. At the time points T1 to T4，the level of SpO

in the traditional group showed a trend of first decreasing and then increasing （

0.05）， while the level of SpO

in the non-pneumoperitoneum group showed no significant fluctuations （

0.05）. The levels of SpO

from T1 to T3 in the non-pneumoperitoneum group were higher than those in the traditional group （

0.05）.At the time points T2 to T4，the traditional group showed a trend of first increasing and then decreasing in PETCO

and Paw （

0.05），while the non-pneumoperitoneum group showed no significant fluctuations in PETCO

and Paw （

0.05）. At the time points T2 and T3， the PETCO

and Paw in the non-pneumoperitoneum group were lower than those in the traditional group （

0.05）. At the time points T1 to T4， MAP and HR in both groups showed a trend of first increasing and then decreasing （

0.05）， and MAP and HR in the non-pneumoperitoneum group were lower than those in the traditional group （

0.05）. There was no statistically significant difference in the incidence of complications between the two groups（

0.05）.

Conclusion

Compared with traditional total laparoscopic hysterectomy and adnexectomy，gasless single-port total laparoscopic hysterectomy and adnexectomy assisted with abdominal wall suspension can reduce the surgical injury，alleviate respiratory and circulatory function，maintain hemodynamic stability， and promote early postoperative recovery of patients.

关键词

免气腹悬吊式装置单孔腹腔镜全子宫及附件切除术呼吸循环功能血流动力学

Keywords

gasless abdominal wall suspensionsingle-port laparoscopytotal hysterectomy and adnexectomyrespiratory and circulatory functionhemodynamics

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