自制入路通道单孔腹腔镜手术治疗妊娠期巨大良性卵巢囊肿的临床分析

目的探讨自制入路通道(port)单孔腹腔镜手术治疗妊娠期巨大良性卵巢囊肿的可行性和安全性。 方法收集2016年3月至2019年3月在青岛妇女儿童医院进行自制入路通道单孔腹腔镜下妊娠期巨大良性卵巢囊肿剥除术的11例患者(其中10例为早孕期、1例为中孕期)的临床资料，对手术时间、术中出血量、术后住院时间、围术期并发症、术后1 d疼痛VAS(Visual Analogue Scale/Score)评分、后续妊娠情况及有无复发等指标进行回顾性分析。 结果11例患者均顺利完成手术，术中无囊肿破裂或囊肿内容物流入腹腔，无患者中转开腹或多孔腹腔镜手术，中位手术时间55(30～120)min，中位术中出血量10(5～50)ml，术后1 d疼痛VAS评分平均1.5分。术后1例出现先兆流产，给予保胎治疗后继续妊娠，无其他术中、术后并发症发生；9例患者术后足月顺利分娩，2例患者顺利妊娠，所有患者术后均未复发。 结论自制入路通道单孔腹腔镜手术治疗妊娠期巨大良性卵巢囊肿安全、有效、经济，不良反应较少，值得临床推广应用。

Clinical analysis of laparoendoscopic single-site surgery using a homemade glove port in the treatment of giant benign ovarian cysts during pregnancy

ObjectiveTo investigate the safety and feasibility of laparoendoscopic single-site surgery(LESS)using a homemade glove port in the treatment of giant benign ovarian cysts during pregnancy. MethodsWe retrospective analyzed the clinical data of 11 patients with giant benign ovarian cysts during pregnancy who underwent single-port laparoscopic assisted ovarian cystectomy at gynecology department of Women and Children's Hospital of Qingdao University from Mar.2016 to Mar.2019.Among them 10 patients were in the first trimester of pregnancy and 1 patient was in the second trimester of pregnancy.The operation time, estimated blood loss, postoperative hospital stay, perioperative complications, VAS score on the first day after surgery, pregnancy outcomes and recurrence data were analyzed. ResultsAll surgeries were successfully completed and no cases were converted to laparotomy or conventional laparoscopy. The median operation time was 55(30-120)min, the median bleeding volume was 10(5-50)ml, and average the VAS score on the first day after surgery was 1.5. One patient experienced threatened abortion one day after the surgery, but was easily treated with Progesterone. After surgery, nine full-term deliveries were achieved, while two cases are still in pregnancy. All the cases had no recurrence. ConclusionsLESS using a homemade glove port is safe and feasible in the treatment of giant benign ovarian cysts during pregnancy, and is more minimally invasive.