摘要
目的探讨无腹壁悬吊无气腹经阴道自然腔道内镜手术(natural orifice transluminal endoscopic surgery,NOTES)下异位妊娠(输卵管切除或输卵管开窗取胚术)手术的可行性和安全性。方法方便选取2020年7—10月该院收治的21例异位妊娠患者为研究对象,拟行腹腔镜下输卵管切除、输卵管开窗取胚术遴选入组进行无腹壁悬吊无气腹经阴道NOTES,观察手术效果。结果19例成功完成,2例异位妊娠因患侧输卵管与周围组织粘连严重,给予气腹条件下继续经阴道单孔腹腔镜下顺利完成。手术时间(43.92±10.39)min,术中出血量(35.75±6.33)mL;术前血红蛋白(96.0±13.2)g/L与术后血红蛋白(93.0±12.7)g/L相比,差异无统计学意义(P>0.05)。术中及术后均无并发症发生。术后胃肠道功能恢复时间(13.42±2.81)h,术后住院时间(2.10±0.12)d,术后24 h视觉模拟评分法评分(0.38±0.12)分,术后随诊时间(3.17±1.04)个月,所有患者的阴道残端切口愈合良好,无明显瘢痕形成。结论无腹壁悬吊无气腹经阴道NOTES输卵管切除、输卵管开窗取胚术是一种安全、可行的方法,且该术式无腹壁切口瘢痕,美容效果好。
Objective To investigate the feasibility and safety of ectopic pregnancy(salpingectomy or fenestration of fallopian tube)under natural orifice transvaginal endoscopic surgery(notes).Methods Selected conveniently 21 patients with ectopic pregnancy admitted to this hospital from July to October 2020 as the research objects.Laparoscopic tubal resection and fenestration of tubal embryos were planned to be selected into the group for transvaginal NOTES without abdominal wall suspension without pneumoperitoneum,and the effect of the operation was observed.Results 19 cases were successfully completed,and 2 cases of ectopic pregnancy were successfully completed under the condition of pneumoperitoneum due to severe adhesion between the affected fallopian tube and surrounding tissues.The operation time was(43.92±10.39)min,and the intraoperative blood loss was(35.75±6.33)mL.There was no statistically significant difference between preoperative hemoglobin(96.0±13.2)g/L and postoperative hemoglobin(93.0±12.7)g/L(P>0.05).No complications occurred during or after the operation.The postoperative gastrointestinal function recovery time was(13.42±2.81)h,the postoperative hospital stay was(2.10±0.12)d,and the visual analog scale score was(0.38±0.12)points after 24 h,the postoperative follow-up time was(3.17±1.04)months.All patients'vaginal stump incisions healed well without obvious scar formation.Conclusion No abdominal wall suspension,no pneumoperitoneum,transvaginal NOTES tubal resection,tubal fenestration and embryo harvesting is a safe and feasible method,and there is no abdominal wall incision scar,and the cosmetic effect is good.
作者
戴金城
潘汉斌
凌幼霞
梁美玲
苏继烨
陈丽影
DAI Jincheng;PAN Hanbin;LING Youxia;LIANG Meiling;SU Jiye;CHEN Liying(Department of Gynecology,Quanzhou Maternal and Child Health Hospital·Children's Hospital,Quanzhou,Fujian Province,362000 China)
出处
《中外医疗》
2021年第31期65-67,76,共4页
China & Foreign Medical Treatment
基金
福建省泉州市科技局科技计划项目科研课题立项(2018N087S)。
关键词
经阴道自然腔道内镜手术
无腹壁悬吊
无气腹
异位妊娠
Transvaginal endoscopic surgery
No abdominal wall suspension
No pneumoperitoneum
Ectopic pregnancy
