Clinical Analysis Of Laparoscopic Laparoscopic Myomectomy

Objectives:To compare the clinical effects of laparoscopic uterine myomectomy and multi-laparoscopic uterine myomectomy,and to evaluate the safety,feasibility and aesthetics of uterine myomectomy by umbilical single-port laparoscopic laparoscopic surgery.Method:Sixty patients with uterine fibroids requiring surgery in Dalian Maternal and Child Health Hospital from April 2017 to April 2018 were randomly divided into the umbilical single-port laparoscopic treatment group(30 cases)and the porous laparoscopic treatment group(30 cases).Observe the age and body mass index of the two groups of patients,the number of uterine fibroids before surgery,the diameter of the largest fibroids,the history of previous abdominal surgery,the maximum diameter of uterine fibroids during surgery,the number of uterine fibroids removed,the amount of bleeding,and the operation time,blood transfusion and para-injury,postoperative hemoglobin concentration changes,anal exhaust time,hospital stay and total hospitalization costs,surgical costs related health economics and other indicators.Pain scores were performed 24 hours and 3 days after surgery using a vasual analogue scale(VAS).The patient and observer scar assessment scale(POSAS)was used to score the incision satisfaction of 3 days postoperatively,1 month and 3 months postoperatively.Statistical analysis was performed on the experimental data using SPSS 20.0 statistical software.Results:1.The age,body mass index,preoperative ultrasound showed the number of uterine fibroids,the diameter of the largest uterine fibroids,and the history of previous abdominal surgery.The difference was not statistically significant(P>0.05).2.Comparison of intraoperative conditions between the two groups: The operation of both groups was successfully completed.There was no intraoperativeblood transfusion,conversion to open surgery and side injury.The single hole group was completed without single hole.There was no significant difference in the diameter of the largest uterine fibroids,the number of uterine fibroids removed,and the amount of bleeding(P>0.05).The operation time of the single-hole group was longer than that of the porous group,and the difference was statistically significant(P<0.05).With the increase in the number of surgical procedures,the operation time of the single-hole group was shortened,and there was no difference between the operation time and the operation time of the porous group in 20 cases.3.Comparison of postoperative conditions between the two groups: There were no complications such as incision hemorrhage,delayed incision healing,incisional hernia,and intestinal obstruction.There were no significant differences in hemoglobin concentration change,anal exhaust time,total hospitalization cost,surgical cost,and24-hour and 3-day pain VAS scores(P>0.05).The patients with scar assessment scale(PSAS)in the umbilical single-port laparoscopic treatment group had lower scores than the multi-laparoscopic treatment group at 3 days,1 month,and 3 months after surgery(P<0.05);3 days,1 month,and 3 months after surgery,the observer scar assessment scale(OSAS)was lower in the umbilical single-port laparoscopic treatment group than in the porous laparoscopic treatment group,and the difference was statistically significant(P < 0.05).Conculsions:1.Compared with traditional multi-hole laparoscopic surgery,umbilical single-port laparoscopic surgery for uterine fibroids has the same surgical effect,and it is safe and feasible without increasing the side injury of the operation and the economic burden of the patient.2.transumbilical single-port laparoscopy is more prolonged than porous laparoscopic surgery,but with the increase of the number of cases,the difference with the time of porous laparoscopic surgery is reduced,20 cases are the same as porous laparoscopy;3.umbilical single-port laparoscopic surgery for uterine fibroids in the minimally invasive,aesthetic,postoperative incision satisfaction and other advantages.