目的:本研究的目的是比较后路切开术或腹部摘除术切除附件结构的妇女的术中和术后结果。
方法:这是一项通过病历回顾进行的回顾性队列研究。人口统计,临床,和手术变量从病历中提取。统计分析包括描述性统计,费希尔的精确检验,Wilcoxon秩和检验,和多变量逻辑回归模型。
方法:2010年至2022年之间的单一学术三级护理中心。
方法:共有718例接受微创卵巢囊肿切除术或卵巢切除术的患者被纳入我们的分析。如果患者同时进行子宫切除术,则将其排除在外。
方法:患者接受微创卵巢切除术或卵巢囊肿切除术,和标本通过腹部摘除术或切开术摘出。
结果:在符合纳入标准的718名患者中,127例(17.7%)进行了切开术,591例(82.3%)进行了腹部拔除。切开术组的手术时间更长(113分钟vs96分钟,p<0.001)和更高的估计失血量(25毫升对10毫升,p<0.001)与腹部摘除组相比。与腹部摘除术组相比,切开术组的恶性肿瘤更多(15.7%vs8.1%,分别,p<0.001)。在调整了潜在的混杂因素后,那些接受了截肢手术的患者更有可能进行两次或两次以上的门诊就诊(OR2.89;95%CI,1.66-5.03;p<0.001),并向诊所打电话或发消息(OR2.08;95%CI,1.35-3.20;p<0.001).没有袖口开裂的发生率,袖带蜂窝织炎,或盆腔脓肿。
结论:通过腹孔部位或后路切开术切除附件标本是标本提取的可行选择,可以根据患者和外科医生的偏好以及患者的因素进行个体化。由于在我们的队列中观察到的术后信息发生率较高,因此接受切开术的患者可能需要更多的术前咨询。
OBJECTIVE: The objective of this study is to compare intraoperative and postoperative outcomes in women undergoing removal of adnexal structures by either posterior culdotomy or abdominal extraction.
METHODS: This is a retrospective cohort study conducted via medical record review. Demographic, clinical, and operative variables were abstracted from the medical records. Statistical analysis consisted of descriptive statistics, Fisher\'s exact tests, Wilcoxon rank sum tests, and multivariable logistic regression models.
METHODS: Single academic tertiary care center between 2010 and 2022.
METHODS: A total of 718 patients were identified and included in our analysis who underwent minimally invasive ovarian cystectomy or oophorectomy. Patients were excluded if they underwent concomitant hysterectomy.
METHODS: Patients underwent minimally invasive oophorectomy or ovarian cystectomy, and specimens were extracted by either abdominal extraction or culdotomy extraction.
RESULTS: Of the 718 patients who met inclusion criteria, 127 (17.7%) underwent culdotomy extraction and 591 (82.3%) underwent abdominal extraction. The culdotomy extraction group had longer operative times (113 minutes vs 96 minutes, p<0.001) and higher estimated blood loss (25 milliliters vs 10 milliliters, p<0.001) compared to the abdominal extraction group. There were more malignancies in the culdotomy extraction than the abdominal extraction group (15.7% vs 8.1%, respectively, p<0.001). After adjusting for potential confounders, those who underwent culdotomy extraction were more likely to have two or more clinic visits (OR 2.89; 95% CI, 1.66-5.03; p<0.001) and call or message the clinic (OR 2.08; 95% CI, 1.35-3.20; p<0.001). There were no incidences of cuff dehiscence, cuff cellulitis, or pelvic abscess in either group.
CONCLUSIONS: Removal of adnexal specimens via abdominal port site or posterior culdotomy incision is a feasible option for specimen extraction and can be individualized based on patient and surgeon preference and patient factors. Those undergoing culdotomy extraction may require more preoperative counseling due to higher rate of postoperative messages seen in our cohort.