Clinica Analysis Of Transumbilical Single-hole Laparoscopic Surgery In Treating Benign Gynecological Diseases

BackgroundTransumbilical single-hole laparoscopic surgery（transumbilical laparoendoscopic single surgery,TU-LESS）uses the natural scar umbilical hole of the human body as the surgical entrance,only one incision was made at the umbilical hole,and a multi-channel PORT platform was placed to complete all surgical procedures.Because of its smaller trauma,the advantage of better postoperative abdominal beauty effect has been favored by gynecological patients.Due to the late start of transumbilical single-hole laparoscopic surgery in China and the certain difficulty in surgery,it has not been widely used in clinical practice.The safetyand feasibility of the treatment of benign gynecological diseases also need a large number of clinical data to further verify.ObjectiveTo explore the feasibility,safety and clinical advantage of transumbilical single-hole laparoscopic surgery for benign gynecological diseases.MethodsClinical data of 292 patients with benign gynecological diseases treated in The First Affiliated Hospital of Xinxiang Medical College from June 2020 to December2021 were collected,According to the different surgical methods,observation group（140cases）and control group（152 cases）,in the observation group,26 patients had ectopic pregnancies,50 benign ovarian tumors,28 uterine fibroids,and 36 other benign uterine lesions,the observation group underwent transumbilical single-hole laparoscopic surgery.and in the control group,30 patients had ectopic pregnancies,48 benign ovarian tumors,32 uterine fibroids,and 42 other benign uterine lesions,the control group performed traditional laparoscopic surgery.General clinical data,tumor size,operating time,postoperative bleeding amount,maximum postoperative body temperature,first postoperative exhaust time,postoperative activity time of postoperative discharge time,postoperative hospitalization time,postoperative pain NRS score of 24hours,incision aesthetic satisfaction CS score,postoperative complications and ovarian function indicators in ovarian tumor diseases were compared.Results1 Comparison of the general clinical data between the two patient groups:In terms of age,BMI and the number of various disease cases in the two groups,there was no significant difference（P>0.05）;Among the uterine fibroids and benign ovarian tumors,Compared to the tumor diameter in the two groups,the difference was also not statistically significant（P>0.05）.2 Comparison of surgery-related data between the two patient groups:During ectopic pregnancy surgery,uterine fibroids,total hysterectomy and the observation group performed intraoperative in vivo benign ovarian tumor removal,the operation time of the observation group was longer than the control group,the difference was statistical significant（P<0.05）;intraoperative bleeding,there was no significant difference between the two groups（P>0.05）.But for the observation group performed surgery for removing benign ovarian tumors in vitro,the operation time of the observation group was shorter than the control group,and the intraoperative bleeding amount was less than the control group,the difference was significant（P<0.05）.Among all kinds of diseases,the observation group had less postoperative ambulation time than the control group,the VAS score was lower than the control group,and the CS score was higher than the first month（P<0.05）;maximum postoperative body temperature,postoperative exhaust time,and postoperative hospital stay were not significantly different between the two groups（P>0.05）.3 Ovarian function of the two groups was compared to the ovarian tumors:Preoperative,the observation group E₂,FSH,and LH compared with the control group,there was no significant difference（P>0.05）.Postoperative,E₂in both observed and control groups was lower than preoperative,FSH and LH were higher than preoperative,the difference was statistically significant（P<0.05）.Postoperative,the ovarian function of the benign ovarian tumor removal performed in the observation group,the levels of E₂,FSH,and LH in the observed group,when compared with the control group,there was no significant difference（P>0.05）;for the ovarian function of vitro benign ovarian tumor removal in the observation group,E₂levels were higher in the postoperative observation group than in the control group,and FSH,LH levels were lower than in the control group,the difference was statistically significant（P<0.05）.4 Postoperative complications were compared between the two groups:The postoperative complication rate in the observation group was 2.14%,the control group was 4.61%,The incidence of postoperative complications in the observed group was slightly lower than that in the control group,however,the difference was not statistically significant（χ~2=1.336,P>0.05）.Conclusions1 Compared with traditional laparoscopic surgery,single-hole transumbilical laparoscopic surgery has the advantages of less trauma,less pain,and better abdominal appearance.2 For young patients with beauty and cystic ovarian tumors,transumbilical single-hole laparoscopic surgery is more appropriate.3 Transumbilical single hole laparoscopic surgery is as safe as feasible as traditional laparoscopy.