| Objective:To compare the results of single-port laparoscopic hysterectomy and multiport laparoscopic hysterectomy in randomized clinical trials,and to explore the clinical value of single-port laparoscopic surgery.METHODS:One hundred patients who underwent surgical removal of the uterus for benign disease were enrolled and explained to the study protocol to understand that they would be randomized to receive single-port laparoscopic or porous laparoscopic surgery and signed informed consent to participate in the trial and surgical procedure.A computer is used to generate 50 random integers in 1-100.The patients were enrolled in the order of1-100 in the order of admission,and the patients with the corresponding numbers of the random numbers were divided into experimental groups,and another 50 were used as the control group.Patients in the experimental group underwent single-port laparoscopic hysterectomy,and the control group underwent porous laparoscopic hysterectomy.All the operations were performed by the same high-grade gynaecologist.Comparing the intraoperative blood loss,duration of surgery,recovery time of ventilation,postoperative hospital stay,surgical complications,hospitalization cost,incision cosmetic effect And surgical satisfaction.Results:The weight of the uterus in the experimental group and the control group were306.05 g(75-635 g)and 350.21 g(82-676 g),respectively.The intraoperative blood loss was 30 ml(10-50 ml)and 27.63(5-80 ml),respectively.The ventilation time was31.58h(24-72h)and 29.05h(24-72h)respectively.The postoperative incision pain scores were 2.89 points(1-4 points)and 3.44 points(1-5 points)respectively.The postoperative hospital stay were 4.11 days(2-8 days)and 4.26 days(2-8 days)respectively;The hospitalization costs were 16121.69 yuan(12735.30-21766.58 yuan),16283.72 yuan(11567.35-21465.20 yuan)respectively.The above differences were not statistically significant(P > 0.05).The duration of surgery in the LESS group averaged83.32.min(71-151 min),the average operation time of the porous laparoscopic group was 65.89 min(48-132 min),and the experimental group was significantly longer than the control group(P <0.05).A total of 97 patients completed telephone follow-up,including 49 in the single-hole group and 48 in the multi-well group;the former had a lower PSAS score than the latter,with statistical significance(P = 0.04).The average PSAS score for the porous laparoscopic group was 11.73 points,compared with 8.74 points for the single-port laparoscopic group.Among the 6 variables of the PSAS score,the scores of pain,itching,thickness and degree of stiffness did not show statistically significant differences between the groups.Postoperative scar color and regularity results were significantly better than the control group,which may play a key role in showing significant differences in total PSAS scores.In both groups,the satisfaction of surgery in the LESS group was slightly higher,but not statistically significant(P =0.11).Conclusion:Single-port laparoscopic surgery is a good alternative to traditional laparoscopic surgery.It can better meet the requirements of patients with scar beauty,and has good safety,effectiveness and economic applicability.It is worth promoting in clinical work.To allow more patients with surgical conditions to obtain a better surgical incision cosmetic effect.The effects of surgery and invasive procedures on the human body are complex.The surgeon,the surgical team,the setting of the energy equipment,thelearning curve,the individualized differences of the patients,and the understanding of the details of the new technology may all affect the outcome of the surgery.Therefore,the selection of appropriate surgical patients,clear surgical ideas,the correct understanding of the operation details is the prerequisite for the smooth implementation of single-hole laparoscopic surgery. |
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