倒刺线缝合子宫血管在经脐单孔腹腔镜下大子宫切除术中的应用

Application of suturing uterine blood vessels with barbed polydioxanone cog thread through transumbilical single-port access large laparoscopic hysterectomy

摘要:

目的 探讨倒刺线缝合子宫血管在经脐单孔腹腔镜下大子宫切除术中的应用。方法 选取2021年6月－2022年6月该院大子宫切除术的患者41例，分为A组（实验组n = 20）和B组（对照组n = 21）。A组采用倒刺线缝合子宫血管行经脐单孔腹腔镜下大子宫切除术，B组采用传统四孔腹腔镜下大子宫切除术。比较两组患者年龄、体重指数（BMI）、盆腹腔手术史、术前术后血红蛋白（HGB）、手术时间、术中出血量、子宫重量、术后24 h疼痛视觉模拟评分法（visual analogue scale，VAS）、术后肛门排气时间和术后住院时间等。结果 两组患者均成功完成手术，无严重并发症发生。A组较B组手术时间明显延长（P < 0.01）；两组患者术中出血量、子宫重量、术后第1天HGB、术后住院时间、术后肛门排气时间和术后24 h疼痛VAS比较，差异均无统计学意义（P > 0.05）。结论 在经脐单孔腹腔镜下大子宫切除术中，采用倒刺线缝合子宫血管，安全、可行，但手术时间比多孔腹腔镜明显延长，随着该技术的逐渐熟练，这种情况将得以改善。

Abstract:

Objective To present our initial experience of suturing uterine blood vessels with barbed polydioxanone cog thread by single-port-access large laparoscopic hysterectomy.Methods A respective non-randomized study with two parallel groups was performed from June 2021 to June 2022. The medical records of a total of 41 patients with enlarged uterus were divided into two groups: The single-port access large laparoscopic hysterectomy group by suturing uterine blood vessels with barbed cog thread (experimental group, n = 20), and the four-port assess laparoscopic hysterectomy group (control group, n = 21). The age, body mass index (BMI), a history of abdominal and pelvic surgery, pre- and post-operative hemoglobin (HGB), operative duration, intraoperative bleeding volume, uterine weight, postoperative pain visual analogue scale (VAS) at 24 h, the first postoperative exhaust time and postoperative length of hospital stay were compared between the two groups.Results 41 patients completed the entire procedure successfully without serious complications. Experimental group had a longer median operative time (P < 0.01). There were no significant differences in intraoperative bleeding volume, uterine weight, HGB on postoperative day 1, postoperative hospital stays, postoperative exhaust time and postoperative 24-hour pain VAS (P > 0.05).Conclusion Our study shows that suturing uterine blood vessels with barbed polydioxanone cog thread in experimental group is safe and feasible for large uterus , but the surgical time is significantly longer than the control group, as the technology becomes more proficient, this situation will be improved.