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1.南京医科大学附属宿迁第一人民医院妇产科,江苏 宿迁223800
2.南京医科大学附属无锡人民医院妇产科,江苏 无锡214023
张金伟,E-mail:huyufeng1000@163.com
收稿:2025-04-10,
纸质出版:2026-01-25
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仲苏静,张金伟,张珍等.经阴道单孔与传统腹腔镜下卵巢囊肿剥除术对育龄女性的影响比较[J].局解手术学杂志,2026,35(01):62-65.
ZHONG Su-jing,ZHANG Jin-wei,ZHANG Zhen,et al.A comparative study of transvaginal single-port versus traditional laparoscopic ovarian cyst enucleation in women of childbearing age[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(01):62-65.
仲苏静,张金伟,张珍等.经阴道单孔与传统腹腔镜下卵巢囊肿剥除术对育龄女性的影响比较[J].局解手术学杂志,2026,35(01):62-65. DOI: 10.11659/jjssx.04E025052.
ZHONG Su-jing,ZHANG Jin-wei,ZHANG Zhen,et al.A comparative study of transvaginal single-port versus traditional laparoscopic ovarian cyst enucleation in women of childbearing age[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(01):62-65. DOI: 10.11659/jjssx.04E025052.
目的
2
明确经阴道单孔与传统腹腔镜下卵巢囊肿剥除术对育龄女性生殖道炎症、卵巢储备功能及粘连的影响。
方法
2
选取南京医科大学附属宿迁第一人民医院2023年8月至2024年12月因罹患卵巢囊肿而行手术治疗的育龄女性78例为研究对象,随机分为传统组和经阴道自然腔道内镜手术(V-NOTES)组,每组39例,分别使用传统多孔腹腔镜和经阴道单孔腹腔镜进行卵巢囊肿剥除术。比较2组患者手术及术后恢复指标、术后生殖道炎症状况、手术前后卵巢储备功能及粘连因子情况。
结果
2
V-NOTES组患者的术中出血量、住院时间、肛门排气时间和术后24 h切口疼痛评分均明显低/短于传统组(
P
<
0.05)。V-NOTES组患者的阴道清洁度Ⅲ~Ⅳ级和阴道pH值
>
4.5比例明显高于传统组(
P
<
0.05)。V-NOTES组患者术后抗苗勒管激素(AMH)水平明显高于传统组,卵泡刺激素(FSH)和雌二醇(E2)水平均明显低于传统组(
P
<
0.05);V-NOTES组患者术后层粘连蛋白(LN)、转化生长因子-β1(TGF-β1)和纤连蛋白(FN)水平均明显低于传统组(
P
<
0.05)。
结论
2
与传统腹腔镜下卵巢囊肿剥除术相比,经阴道单孔手术有利于患者术后快速康复及卵巢储备功能恢复,降低术后粘连风险,但会对阴道微环境造成一定不良影响。
Objective
2
To clarify the effects of transvaginal single-port versus traditional laparoscopic ovarian cyst enucleation on genital tract inflammation, ovarian reserve function and adhesion in women of childbearing age.
Methods
2
A total of 78 childbearing-aged women with ovarian cysts scheduled for surgical treatment in Affiliated Suqian First People's Hospital of Nanjing Medical University from August 2023 to December 2024 were selected and randomly assigned to the traditional group and the transvaginal natural orifice transluminal endoscopic surgery (V-NOTES) group, with 39 cases in each group, who received traditional multi-port laparoscopy and transvaginal single-port laparoscopy respectively for ovarian cyst enucleation respectively. The surgical and postoperative recovery indexes, postoperative genital tract inflammation status, and ovarian reserve function and adhesion factor before and after surgery were compared between the two groups.
Results
2
The intraoperative blood loss, hospital stay, time to anal exhausting and score of incision pain 24 hours after surgery in the V-NOTES group were significantly lower/shorter than those in the traditional group (
P
<
0.05). The proportions of patients with vaginal cleanliness grades from Ⅲ to IV and vaginal pH value
>
4.5 in the V-NOTES group were significantly higher than those in the traditional group (
P
<
0.05). The level of anti-Müllerian hormone (AMH) after surgery in the V-NOTES group was significantly higher than that in the traditional group, whereas the levels of follicle-stimulating hormone (FSH) and estradiol (E2) were significantly lower than those in the traditional group (
P
<
0.05). The levels of laminin (LN), transforming growth factor-β1 (TGF-β1) and fibronectin (FN) after surgery in the V-NOTES group were significantly lower than those in the traditional group
(P
<
0.05).
Conclusion
2
Compared with traditional laparoscopic ovarian cyst enucleation, transvaginal single-port surgery facilitates faster postoperative recovery, better preservation of ovarian reserve function, and a lower risk of adhesion formation, while it has certain bad effects on the vaginal microenvironment.
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