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| Comparison of the effect of single port laparoscope and multi-port laparoscope used in hysteromyomectomy |
| 1. Jiaxing Maternity and Child Health Care Hospital, Jiaxing, Zhejiang Province, 314000；2. Zhejiang Xinan International Hospital, Jiaxing |
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Abstract To analyze the effect of single port laparoscope (SPLS) and multi-port laparoscope (MPLS) used in hysteromyomectomy. Methods: 120 patients diagnosed as uterine fibroids were randomly divided into two groups (60 cases in each group) from April 2018 to April 2020. The patients in the observation group had undergone MPLS surgery, and the patients in the control group had undergone SPLS surgery. The surgical indicators, the levels of inflammatory indicators ［interleukin (IL-6), high-sensitivity C-reactive protein (hs-CRP)］, and serum interferon-γ (IFN-γ) of the patients in the two groups before surgery and 3 days after surgery, and the levels of ovarian reserve function ［follicle stimulating hormone (FSH), estradiol (E2), luteinizing hormone (LH), basal sinusoidal cells (AFC)］ of the patients in the two groups before surgery and 1 month after surgery were analyzed. The complication rate of the patients in the two groups was counted, and the beauty effect of the patients in the two groups was evaluated. All the patients were followed up at least 1 year, and the situations of the abnormal menstruation, the re-pregnancy, and the recurrence of fibroids of the patients in the two groups were recorded. Results: The postoperative anal exhaust time, the postoperative visual analogue score (VAS), and the hospitalization time of the patients in the observation group were significantly better than those of the patients in the control group, and the operation time of the patients in the observation group was significantly longer than that of the patients in the control group (all P<0.05). There were no significant difference in bleeding loss during operation of the patients between the two groups (P>0.05). The levels of IL-6 and Hs-CRP of the patients in both groups in 3 days after operation had increased significantly, but which of the patients in the observation group were significantly lower than those of the patients in the control group, The IFN-γ level of the patients in the observation group was significantly lower than that of the patients in the control group (all P<0.05). The levels of FSH and LH of the patients in both groups in 1 month after operation had increased significantly, but the E2 level had decreased significantly, the change degree of which of the patients in the observation group were significantly lower than those of the patients in the control group (all P<0.05). The AFC value of the patients in both groups before operation, in 1 month and 6 months after operation were similar (P>0.05). There were no significant difference in the serum FSH, LH and E2 levels of the patients in 6 month after operation between the two groups (P>0.05). There was no significant difference in the complication rate (5.0% vs. 3.3%) of the patients between the two groups (P>0.05). BIS score of the patients in the observation group was significantly lower than that of the patients in the control group, and CS score of incision aesthetic satisfaction of the patients in the observation group was significantly higher (P<0.05). The patients in both groups were followed up for 14-24 months, with a median of 18 months of followed up. Menstruation of the patients in the observation group was normal, and the abnormal menstruation of one patient in the control group was observed. There were no recurrence of myoma of the patients occurred in both groups. There were 8 (13.3%) cases with repregnancy in the observation group and 3 (5.0%) cases with repregnancy in the control group. There were no significant differences in different indexes of the patients during followed up between the two groups (P>0.05). Conclusion: SPLS and MPLS used in hysteromyomectomy of the patients have the similar short-term and long-term effects, but SPLS causes less inflammatory response, and can improve their IFN-γ level, can be more conducive to the recovery of ovarian reserve function of the patients early, and can help them obtain better cosmetic effect.
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