Single-port Access Subtotal Laparoscopic Hysterectomy: A Prospective Case-Control Study

被引:26
|
作者
Angioni, Stefano [1 ]
Pontis, Alessandro [1 ]
Pisanu, Adolfo [1 ]
Mereu, Liliana [2 ]
Roman, Horace [3 ]
机构
[1] Univ Cagliari, Dept Surg Sci, Cagliari, Italy
[2] Hosp Santa Maria Chiara, Dept Obstet & Gynaecol, Trento, Italy
[3] Univ Rouen, Dept Obstet & Gynaecol, Rouen, France
关键词
Single-port access laparoscopy; Laparoscopic subtotal hysterectomy; SPAL; RANDOMIZED-CONTROLLED-TRIAL; SUPRACERVICAL HYSTERECTOMY; RESECTION; ADVANTAGES; SURGERY; WOMEN;
D O I
10.1016/j.jmig.2015.03.011
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Study Objective: The objective was to evaluate the perioperative outcomes, safety, and patient acceptance of single-port access laparoscopic subtotal hysterectomy (SPAL-SH) in comparison with conventional multiport access laparoscopic subtotal hysterectomy (MPAL-SH). Design: Case-control study. Canadian Task Force Classification II-2. Setting: The study was conducted at university hospitals in Cagliari, Italy, and Rouen, France. Patients: Sixty-one women with metrorrhagia, abnormal uterine bleeding with uterine myomas, or symptomatic adenomyosis were included in the study. Interventions: Thirty-one patients underwent SPAL-SH, and 30 patients underwent conventional MPAL-SH. Measurements and Main Results: We analyzed the data to compare the outcomes of SPAL-SH versus MPAL-SH. Patients in the SPAL-SH group had longer operative times than those in the MPAL-SH group (p < .001) but shorter hospital stays (p < .001). Postoperative pain immediately after surgery, after 6 hours, and after 24 hours were lower in the SPAL-SH group (p < .001). The SPAL-SH group reported significantly higher cosmetic satisfaction at 1, 4, and 24 weeks after surgery (p < .01). Conclusion: We conclude that SPAL-SH is a feasible and safe alternative to standard MPAL-SH in selected patients. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. In addition, SPAL-SH has a definite benefit in relation to body image and cosmesis. (C) 2015 AAGL. All rights reserved.
引用
收藏
页码:807 / 812
页数:6
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