A Comparative Study On The Clinical Efficacy Of Transumbilical Single-hole Laparoscopy And Traditional Porous Laparoscopy In Myomectomy

Objective: with the innovation of ideas and the progress of instruments and experience,natural cavity endoscopic surgery and transumbilical single-hole laparoscopic surgery have been recognized and accepted by doctors and patients increasingly because of their high aesthetic and minimally invasive incision.Among them,the application of transumbilical single-hole laparoscopy in the field of gynecology is also increasing at the same time.However,due to the high difficulty coefficient and relatively few applications of single-hole laparoscopic myomectomy,there are few reports at home and abroad on the application of the two methods in clinic.therefore,through a comparative analysis of the clinical effects of the two methods in the treatment of uterine leiomyoma,this paper shows the feasibility,advantages and effects of transumbilical single-hole laparoscopy in uterine myomectomy.Methods: a total of 30 patients who underwent laparoscopic myomectomy in our hospital from January 2019 to June 2020 were divided into two groups: transumbilical single hole laparoscopy group(n = 15)and traditional porous laparoscopy group(n = 15).There was no significant difference between the two groups in the data(age,body mass index,previous history of abdominal surgery,number and size of leiomyoma),but there was no significant difference between the two groups.Intraoperative condition: the time of intraoperative operation and the amount of intraoperative bleeding;2)Postoperative recovery: the decrease of postoperative hemoglobin,the highest body temperature after 24 hours,postoperative hospital stay,postoperative complications: record postoperative bleeding,incision inflammation,incision hernia,postoperative intestinal obstruction and other complications;3)Postoperative incision satisfaction: the visual analogue scale((vasual analogue scale,VAS)VAS score was used 24 hours after operation,and the aesthetic satisfaction of incision was examined in outpatient clinic 1 month after operation.The experimental data were analyzed by SPSS20.0 statistical software,and the counting data were analyzed by T test.Results:1.There was no significant difference in the clinical data between the two groups: patient’s age,body mass index((BMI)),previous abdominal surgery,the number and size of uterine leiomyoma revealed by ultrasound before operation.2.Comparing the operation process between the two groups: all the patients completed smoothly,no additional blood transfusion was needed,and no conversion to laparotomy was found during the operation.In the single hole group,the single hole is completed,and there is no need for additional puncture holes.There was no significant difference in the number of hysteromyomas removed and the amount of bleeding during operation(P >0.05).Compared with the operation time of transumbilical single-hole myomectomy group,the operation time was not prolonged,and the difference was not statistically significant(P > 0.05).3.The postoperative conditions of the two groups were compared: there was no significant difference in the range of hemoglobin concentration before and after operation,24 hours after operation,the highest body temperature and postoperative hospital stay(P>0.05).There were no postoperative complications such as incision infection,poor wound healing,incision hernia and so on.There was significant difference in the pain score after 24 h VAS.One month after operation,the incision satisfaction score of the patients treated with single umbilical hole was higher than that of the patients treated with single umbilical hole,and the difference was statistically significant(P <0.05).Conclusions:1.Compared with the traditional porous laparoscopic myomectomy,transumbilical single-hole laparoscopy is feasible,safe and cosmetic in the clinical treatment of uterine leiomyoma.2.In the process of sample extraction in transumbilical single-hole laparoscopic myomectomy,the bag device was used to quickly remove the myoma with a scalpel without the use of an electric crusher,which prevented potential injuries such as pelvic and abdominal tumor spread caused by the pulverizer,and reduced the advantages of traditional use of rotary cutters in the occurrence of incisional hernia after incision.3.In the application of transumbilical single-hole laparoscopic myomectomy,it is difficult to suture the tumor cavity,and the operation time is longer than that of traditional porous laparoscopy.however,the operator is familiar with and mastered the basic operation skills of conventional laparoscopy for a long time,repeated training is the key to successful operation and reduce the operation time.4.The postoperative incision pain score of patients undergoing transumbilical single-hole laparoscopic myomectomy is lower than that of traditional porous laparoscopic myomectomy,and the incision aesthetic satisfaction and acceptance are higher,which has the advantages of improving postoperative aesthetics.