Comparison of three umbilical entry sites for intraperitoneal access by the direct trocar insertion technique: a randomized pilot study.

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY
Ghazal Mansouri, Afsaneh Nikseresht, Fatemeh Karami Robati, Hamid Salehiniya, Leila Allahqoli, Ibrahim Alkatout
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引用次数: 0

Abstract

Objective: The most effective methods and entry sites for laparoscopic surgery remain a subject of ongoing investigation and discussion. The purpose of the study was to analyze and compare three umbilical entry sites for intraperitoneal access using the direct trocar insertion technique.

Material and methods: A randomized pilot study was conducted between March 2021 and January 2023, involving women eligible for laparoscopic gynecological surgery. The women were allocated to one of three equally sized groups based on trocar entry points: subumbilical, supraumbilical, or umbilical. Success and failure rates of trocar entry, factors influencing success or failure, and early and late complications were systematically evaluated and compared across groups.

Results: A total of 243 patients, with a mean age of 32.93±8.33 years, were included in three groups of 81 each. Trocar entry success rates were 97.5%, 89.2%, and 89.5% in the supraumbilical, umbilical, and subumbilical groups, respectively (p>0.05). Failed trocar entry was significantly associated with age, gravidity, body mass index (BMI), waist circumference, hip circumference, and abdominal subcutaneous fat thickness (p<0.001). Regression analysis revealed that, in the subumbilical group, higher gravidity [odds ratios (OR): 0.390, 95% confidence interval (CI): 0.174-0.872, p=0.022) and greater abdominal subcutaneous fat thickness (OR: 0.090, 95% CI: 0.019-0.431, p=0.03) were associated with lower odds of successful trocar entry. In contrast, in the umbilical group, a higher waist circumference was associated with lower odds of successful trocar entry (OR: 0.673, 95% CI: 0.494-0.918, p=0.012). None of the covariates were significant in the supraumbilical group.

Conclusion: The study highlighted the importance of selecting the appropriate trocar entry site in laparoscopic gynecological surgery. Surgeons should consider factors such as age, gravidity, BMI, waist circumference, hip circumference, and abdominal subcutaneous fat thickness, as these factors significantly influence the success of trocar entry.

通过套管直接插入技术进行腹腔内通路的三个脐部入口比较:随机试验研究。
目的:腹腔镜手术最有效的方法和进入部位仍是一个不断研究和讨论的课题。本研究的目的是分析和比较使用直接套管插入技术进行腹膜内入路的三个脐部入路部位:在 2021 年 3 月至 2023 年 1 月期间进行了一项随机试验研究,对象是符合腹腔镜妇科手术条件的妇女。根据套管插入点(脐下、脐上或脐部),这些女性被分配到三个同等规模的组别中的一个。对套管插入的成功率和失败率、影响成功或失败的因素以及早期和晚期并发症进行了系统评估,并在各组间进行了比较:三组共纳入 243 例患者,每组 81 例,平均年龄(32.93±8.33)岁。脐上、脐下和脐下组的套管插入成功率分别为 97.5%、89.2% 和 89.5%(P>0.05)。套管插入失败与年龄、孕酮、体重指数(BMI)、腰围、臀围和腹部皮下脂肪厚度显著相关(p 结论:该研究强调了在腹腔镜妇科手术中选择合适的套管入口部位的重要性。外科医生应考虑年龄、孕酮、体重指数、腰围、臀围和腹部皮下脂肪厚度等因素,因为这些因素对套管插入的成功与否有很大影响。
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来源期刊
CiteScore
2.40
自引率
7.10%
发文量
56
期刊介绍: Journal of the Turkish-German Gynecological Association is the official, open access publication of the Turkish-German Gynecological Education and Research Foundation and Turkish-German Gynecological Association and is published quarterly on March, June, September and December. It is an independent peer-reviewed international journal printed in English language. Manuscripts are reviewed in accordance with “double-blind peer review” process for both reviewers and authors. The target audience of Journal of the Turkish-German Gynecological Association includes gynecologists and primary care physicians interested in gynecology practice. It publishes original works on all aspects of obstertrics and gynecology. The aim of Journal of the Turkish-German Gynecological Association is to publish high quality original research articles. In addition to research articles, reviews, editorials, letters to the editor, diagnostic puzzle are also published. Suggestions for new books are also welcomed. Journal of the Turkish-German Gynecological Association does not charge any fee for article submission or processing.
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