Comparative efficacy of transumbilical single-incision versus multiport laparoscopic ovarian cystectomy in patients with ovarian cysts
10.3760/cma.j.cn101721-20250313-00119
- VernacularTitle:经脐单切口与多孔腹腔镜卵巢囊肿剔除术治疗卵巢囊肿患者的效果比较
- Author:
Meng LIU
1
;
Xinyue XU
1
;
Yuyan DENG
1
Author Information
1. 四川省成都市第三人民医院妇产科，成都 610000
- Publication Type:Journal Article
- Keywords:
Ovarian cyst;
Laparoscopec ovarian cystectomy;
Stress response;
Inflammatory factor
- From:
Clinical Medicine of China
2025;41(4):253-259
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of transumbilical single-incision laparoscopic ovarian cystectomy versus multiport laparoscopic ovarian cystectomy in patients with ovarian cysts.Methods:Clinical data of 132 patients treated at Chengdu Third People's Hospital (January-December 2021) were retrospectively analyzed. Patients were divided into transumbilical single-incision laparoscopic ovarian cystectomy group ( n=70) and multiport laparoscopic ovarian cystectomy group ( n=62). Surgical parameters (operative time, blood loss, bowel recovery time, ambulation time, hospital stay), ovarian reserve function (LH, estradiol, FSH, AMH, inhibin B) both preoperatively and postoperatively, stress response (norepinephrine, cortisol), inflammatory markers (hs-CRP, IL-6, TNF-α), VAS pain scores at 24 h postoperative, scar satisfaction at 1 month and complication rates were compared between both group. Continuous data were expressed as xˉ± s, independent t-test was used on comparison between groups, while paired t-test was used on comparison before and after treatment, categorical data were expressed as n(%), χ2 test was used on comparison between groups. Results:The transumbilical single-incision laparoscopic ovarian cystectomy group had a shorter time on bowel recovery [(16.3±2.2) h vs. (20.8±3.0) h, t=9.87, P<0.001], ambulation [(12.9±2.6) h vs. (15.1±2.9) h, t=4.59, P<0.001] and hospitalization [(3.6±0.8) days vs. (5.3±1.1) days, t=9.65, P<0.001]. Both groups showed postoperative increases in LH, FSH, inhibin B, AMH [single-incision group: (13.2±3.4) U/L vs. (10.7±2.5) U/L, (9.4±1.6) U/L vs. (7.4±2.0) U/L, (66±13) μg/L vs. (44±8) μg/L, (5.2±1.2) μg/L vs. (1.7±0.4) μg/L, t values were 7.00、9.30、17.53、36.60, respectively, all P<0.001, multiport group: (14.1±3.6) U/L vs. (11.4±2.2) U/L, (9.8±1.8) U/L vs. (7.8±2.2) U/L, (62±15) μg/L vs. (43±8) μg/L, (4.9±1.1) μg/L vs. (1.7±0.4) μg/L, t values were 6.60、7.87、13.01、35.70, respectively, all P<0.001] and decreased estradiol [single-incision group: (304±29) pmol/L vs. (327±36) pmol/L, multiport group: (295±30) pmol/L vs. (329±37) pmol/L, t values were 5.92 and 7.99, respectively, both P<0.001], with no intergroup differences ( P>0.05). On postoperative day 1, the levels of serum NE, cortisol, hsCRP, IL-6, and TNF-α in both groups of patients were higher than those before surgery [single-incision group: (315±25) μg/L vs. (261±38) μg/L, (373±31) μg/L vs. (285±41) μg/L, (17.5±3.0) mg/L vs. (5.9±1.4) mg/L, (131±14) ng/L vs. (84±9) ng/L, (69±6) ng/L vs. (48±4) ng/L, t=14.34,20.45,44.11,34.19,35.14, respectively, all P<0.001; multiport group: (348±28) μg/L vs. (264±36) μg/L, (401±35) μg/L vs. (281±43) μg/L, (26.8±3.4) mg/L vs. (6.0±1.4) mg/L, (151±17) ng/L vs. (82±10) ng/L, (84±8) ng/L vs. (47±4) ng/L, t values were 20.67,25.74,68.24,40.24,48.56, respectively, all P<0.001], and the multiport group was higher than the single-incision group( t values were 7.12、4.94、16.89、7.60、11.54, respectively, all P<0.001). At 24 h postoperative, VAS scores was lower in transumbilical single-incision laparoscopic ovarian cystectomy group compared to multiport laparoscopic ovarian cystectomy group [(3.1±0.6) points vs. (4.3±0.9) points, t=4.41, P<0.001]. One month postoperative, scar satisfaction was higher in transumbilical single-incision laparoscopic ovarian cystectomy group compared to multiport laparoscopic ovarian cystectomy group [(21.0±1.5) points vs. (19.7±2.0) points, t=4.41, P<0.001].Difference on complications rate between groups was not statistically significant [14.3% (10/70) vs 21.0% (13/62), χ2=1.02, P=0.312]. Conclusion:Compared to multiport laparoscopy, transumbilical transumbilical single-incision laparoscopic ovarian cystectomy accelerates recovery, reduces pain, improves cosmetic outcomes, and minimizes surgical stress/inflammatory responses without compromising ovarian reserve or increasing complications.
