Curative Effect Of Laparoendoscopic Single-site Surgery For Benign Ovarian Tumor

Background and ObjectiveBenign ovarian tumor and ovarian non-neoplastic mass account for more than two-thirds of the ovarian tumor,And most of them occur in women of childbearing age,Surgical treatment is required when the tumor is larger or the symptoms are obvious.With the development of gynecological minimally invasive technique and surgical instruments,laparoscopic surgery has been widely used in many gynecological operations.Traditional multiport laparoscopy has the advantages of small wound,less complications and recover quickly after operation,It can meet the needs of most patients.Traditional multiport laparoscopy is more and more popular among gynecologists and female patients.Therefore,Traditional multiport laparoscopy has gradually become the standard operation for benign ovarian tumors.With the infinite pursuit of beauty,it is hoped that the postoperative abdominal wall wound will be smaller and smaller,even without abdominal wall wound,and the concept of NOTES(natural orifice transluminal endoscopic surgery)was put forward while ensuring the therapeutic effect.The umbilical cord is a natural scar of human body.The umbilical features of different races and groups vary greatly.The skin of the umbilical part is hidden,and the small-scale changes are not easy to attract people's attention.These features of the umbilical cord provide a prerequisite for the study of scar-free operation through the umbilical cord approach.Umbilical laparoendoscopic single-site surgery(U-LESS)refers to a surgical incision in the umbilical cord as a point of approach,The operation device is put into the abdominal cavity through self-made or special single-port multi-channel equipment to complete the operation.The LESS incision at the umbilicus is 20~30 mm long.which is relatively large,so the removed tissue can also be removed through the single orifice of the umbilical cord during the operation,which is more rapid and is currently regarded as a more minimally invasive method of operation.Umbilical laparoendoscopic single-site surgery is in accordance with the minimally invasive concept of the gynecological operation,which is of great concern to the women and women,and the laparoendoscopic single-site surgery has been developed rapidly in the application of the gynecological operation in recent years.Materials and methods1.MaterialsClinical data of 86 patients with benign ovarian tumors undergoing surgical treatment in the Second Affiliated Hospital of Zhengzhou University from January2017 to December 2018.According to the different operation methods,they were divided into two groups:observation group of 43 patients(umbilical laparoendoscopic single-site surgery)and control group of 43 patients(traditional multiport laparoscopy).Inclusion criteria:(1)All confirmed by pathology and imaging examination;(2)Ovarian tumor diameter smaller than 10cm;(3)BMI less than 30kg/m~2;(4)Informed consent signed by patient and/or family;Exclusion standard:(1)Severe hepatic and renal insufficiency;(2)Severe heart and lung dysfunction;(3)Coagulation dysfunction;(4)Severe pelvic and abdominal adhesion;(5)History of major surgery.2.MethodsThe two groups were compared with each other in terms of intraoperative bleeding,operative time,postoperative hospital stay,intraoperative and postoperative complications,degree of pain 24 hours and 72 hours after operation,and beauty satisfaction score after operation.Statistical methodsStatistical analyses were performed using the computer software SPSS statistics version 22.0.Measurement data were expressed as t-test(?x±s),Count data were analyzed by chi-square test,The value of p<0.05 was considered statistically significant.Results1.Analysis and comparative of general data between two groups of patientsOf the 86 patients with benign ovarian tumors,43 patients in the control group were treated with traditional porous laparoscopy,and 43 patients in the observation group underwent umbilical laparoendoscopic single-site surgery.There was no significant difference in age,pathological type,BMI,tumor diameter between the two groups(p>0.05).2.Analysis and comparative of surgical effects between two groupsOperation was successfully completed,and there were no serious complications in both groups.The operative time in the laparoendoscopic single-site surgery group(150.163±26.346 min)was longer than that in the traditional multiport laparoscopy group(105.256±23.619min)(p<0.05).There was no significant difference in intraoperative bleeding and postoperative hospital stay(p>0.05).3.Comparison of postoperative pain score and cosmetic satisfaction between the two groupsThe post-operative 24h VAS score in the observation group(1.279±0.504)was lower than that in the control group(1.837±0.660).and there was a significant difference between the two groups(p<0.05).The score of postoperative cosmetology satisfaction was higher in the observation group(4.140±0.413)than that in the control group(3.302±0.513)(p<0.05).Conclusions1.It is safe and feasible to operate ovarian benign tumor by umbilical laparoendoscopic single-site surgery,which can be used to treat benign gynecological diseases.2.umbilical laparoendoscopic single-site surgery can relieve pain 24 hours after operation and has obvious cosmetic effect compared with traditional multiport laparoscopy.3.The duration of umbilical laparoendoscopic single-site surgery is longer than that of traditional multiport laparoscopy,which requires further familiarity and skillful operation by gynecologists.