Опубликовать статью

Информационное партнерство

Инфоресурсы

Контакты

«

Vol. 19, Art. 40 (pp. 552-560)    |    2018       

»

Single port laparoscopic hysterectomy in patients with myoma uteri in comparison with traditional and robot assisted laparoscopy

B.L.Tsivyan1,2, E.V.Konstantinov1,2, K.V. Puchkov3.4, S.V.Vardanyan1,2

1 SPb GBUZ "City Hospital N 40", Sestroretsk;
2 Federal State Budget Educational Institution of Higher Medical Education North-West State Medical University named after I.I. Mechnikov ",
RF Ministry of Health, St. Petersburg
3 Ryazan State Medical University. Academician I. P. Pavlov
4 Swiss University Clinic (Moscow)

Brief summary

Objective: Comparative analysis of the results of a laparoscopic single port, conventional laparoscopic and robotic access proceeding hysterectomy in patients with myoma uteri. Methods: The study was performed in the City hospital N40 (Saint Petersburg), the Swiss University clinic (Moscow) between 2012 to 2017. 117 patients with uterine myoma were operated, 39 of them (33.3%) underwent single - port laparoscopic hysterectomy, 41 (35%) - traditional laparoscopic hysterectomy, 37 (31.6%)-robot-assisted surgery. Outcome measures, including operating time, blood loss, rate of complications, visual analogical pain score, cosmesis and length of hospital stay were registered. Results: Mean operating time in the group of single - port access was 126,0?6,6 min, in comparison with conventional laparoscopy -124,2?4,0 min, p=0,406. Estimated blood loss did not differ statistically in the group of traditional laparoscopic and single - port access (95.5 7.5 ml, compared to 96.0 11.2 ml, p= 0.485). Hospital stay was significantly less in the group of single-port access - 5.0 0.5 days (p=0.001). There were no conversions to ?open? total abdominal hysterectomy. In one case of single-port hysterectomy (2.56%), an additional trocar was required because of atypical localization of the myoma. Conclusion: Single-port hysterectomy is a feasible and safe technique, with no major complications.


Key words

hysterectomy; myoma uteri, single-port

Reference list

1. Aarts JWM, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BWJ, Kluivers KB. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD003677. DOI: 10.1002/14651858.CD003677.pub5


2. Visockii M.M., Sazonova E.O. Laparoskopicheskaya gisterektomiya: sovremennii vzglyad. M.: Dinastiya; 2013. [Vysotskii MM, Sazonova EO. Laparoskopicheskaya gisterektomiya: sovremennyi vzglyad. M.: Dinastiya; 2013. (In Russ.)]


3. Michelle Louie, Paula D. Strassle et al. Uterine weight and complications after abdominal, laparoscopic, and vaginal hysterectomy. American Journal of Obstetrics and Gynecology, Volume 219, Issue 5, November 2018, Pages 480.e1-480.e8


4. Pelosi MA, Pelosi MA 3rd. Laparoscopic hysterectomy with bilateral salpingo-oophorectomy using a single umbilical puncture. N J Med 1991;88:721-6.


5. Fanfani F, Monterossi G, Fagotti A, Scambia G. Laparoendoscopic single-site hysterectomy: is it safe and feasible? Curr Opin Gynecol Obstet. 2014; 26:275-80.


6. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: Five-year experience. Ann Surg 2009;250: 187-96.


7. Sandberg, E.M., Hehenkamp, W.J.K., Geomini, P.M. et al. Arch Gynecol Obstet (2017) 296: 597. https://doi.org/10.1007/s00404-017-4467-9


8. Sandberg EM1, la Chapelle CF1, van den Tweel MM1, Schoones JW2, Jansen FW3,4. Laparoendoscopic single-site surgery versus conventional laparoscopy for hysterectomy: a systematic review and meta-analysis. Arch Gynecol Obstet. 2017 May;295(5):1089-1103. doi: 10.1007/s00404-017-4323-y. Epub 2017 Mar 29.


9. Song T1, Kim ML, Jung YW, Yoon BS, Joo WD, Seong SJ. Laparoendoscopic single-site versus conventional laparoscopic gynecologic surgery: a metaanalysis of randomized controlled trials. Am J Obstet Gynecol. 2013 Oct;209(4):317.e1-9. doi: 10.1016/j.ajog.2013.07.004. Epub 2013 Jul 13.

Журнал основан 16 ноября 2000г.
Выдано Министерством РФ по делам печати, телерадиовещания и средств массовых коммуникаций

(c) Перепечатка материалов сайта Medline.Ru возможна только с письменного разрешения редакции