Clinical Study Of Transumbilical Single-port Laparoscopic Myomectomy For Giant Uterine Leiomyoma

Objective: By comparing the clinical effects of transumbilical single-port laparoscopic myomectomy and conventional laparoscopic myomectomy,the feasibility and safety of transumbilical single-port laparoscopic myomectomy in the treatment of myoma diameter greater than 8 cm giant uterine fibroids were discussed.Methods: The clinical information of 60 patients of myoma diameter greater than8.0 cm who underwent laparoscopic myomectomy in the gynecology department of××××× Hospital from April 2020 to April 2022 were retrospectively analyzed.According to the surgical methods,they were divided into single-port laparoscopic myomectomy and conventional laparoscopic myomectomy,including 20 cases of single-port laparoscopic surgery and 40 cases of conventional laparoscopic surgery.Observe and compare the general data of the two groups of patients with giant uterine fibroids,such as age,body mass index,abdominal surgery history,fibroid size,and fibroid type;surgical related indicators,such as operation time,intraoperative blood loss,preoperative and postoperative hemoglobin changes,and complications;postoperative recovery,such as postoperative 24 hours visual analogue scale,postoperative first anal exhaust time,hospitalization days,etc.;and postoperative follow-up incision satisfaction score.SPSS26.0 statistical software was used to analyze the collected data.Results:1.Comparing the general clinical conditions of the two groups of patients before surgery,such as age,body mass index,history of abdominal surgery,myoma size and myoma type,the statistical results showed no significant difference(P>0.05).2.All the cases included in this study were resoundingly completed the operation.There was no additional incisions in the single-port laparoscopic group.There was no conversion to laparotomy in the single-port laparoscopic group and the conventional laparoscopic group.There were no complications during the procedure.3.Compared with the intraoperative situation of the single-port laparoscopic group and the conventional laparoscopic group,there was no observably difference in the intraoperative blood loss,preoperative and postoperative hemoglobin drop between the two groups(P>0.05).The operation time of the single-port laparoscopic group was149±48.44 minutes longer than that of the conventional laparoscopic group 116±39.05minutes(P=0.01).4.There was no dramatically difference in anal exhaust time between the two groups(P>0.05).The 24-hour visual analogue scale(VAS)score of the single-port laparoscopic group was significantly lower than that of the traditional laparoscopic group(3.15±0.99 vs 3.93±1.31,P=0.02).The hospitalization time of the single-port laparoscopic group was 4.40±0.94 days,which was significantly shorter than that of the traditional laparoscopic group 5.70±0.91 days(P=0.00).5.The body image score(BIS)score of the single-port laparoscopic group at 1month after operation was 4.75±1.30,which was considerably lower than that of the traditional laparoscopic group 6.85±1.23,and the difference was substantially significant(P=0.00);the cosmetic score(CS)score of the single-port laparoscopic group was19.30±2.03 points higher than that of the conventional laparoscopic group 16.88±2.03 points,and the difference was considerably significant(P=0.00).Conclusions: Compared to conventional laparoscopic myomectomy,single-port laparoscopic myomectomy for giant uterine fibroids with a diameter of more than 8 cm has the same surgical effect,without increasing surgical complications and other injuries.Therefore,for the treatment of huge uterine fibroids,single-port laparoscopic surgery is safe and effective.Although the operation time of single-port laparoscopy is longer than that of conventional laparoscopy,it has less postoperative pain.ERAS,a concept of improved recovery after surgery,is strongly supported by the fact that postoperative recovery and hospital stay are both accelerated.Moreover,the aesthetic effect of the surgical incision is obvious,which meets the aesthetic requirements of women.The postoperative follow-up results of patients show that it has high satisfaction and good clinical application value.It can be applied in patients with giant uterine fibroids abroad.