Application of single-port procedure and ERAS management in the laparoscopic myomectomy

Abstract Objective Advances in surgical techniques and perioperative management are the two major contributing factors to improved surgical outcomes. The purpose of the current study was to compare the efficacy of single-port surgery and perioperative enhanced recovery after surgery (ERAS) managemen...

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Main Authors: Jing Wang, Xiaomin Xu, Jingui Xu
Format: Article
Language:English
Published: BMC 2023-08-01
Series:BMC Women's Health
Subjects:
Online Access:https://doi.org/10.1186/s12905-023-02550-6
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author Jing Wang
Xiaomin Xu
Jingui Xu
author_facet Jing Wang
Xiaomin Xu
Jingui Xu
author_sort Jing Wang
collection DOAJ
description Abstract Objective Advances in surgical techniques and perioperative management are the two major contributing factors to improved surgical outcomes. The purpose of the current study was to compare the efficacy of single-port surgery and perioperative enhanced recovery after surgery (ERAS) management in laparoscopic myomectomy. Methods The present study included 120 patients undergoing laparoscopic myomectomy in the Gynecological Ward of Quzhou Affiliated Hospital of Wenzhou Medical University. According to the traditional perioperative management mode and ERAS management, multi-port and single-port procedures, all patients were assigned to the Conventional-SPLS (Single-Port Laparoscopic Surgery with conventional perioperative care) group (n = 34), Conventional-Multi (multi-port laparoscopic surgery with conventional perioperative care) group (n = 47), and ERAS (multi-port laparoscopic surgery with ERAS perioperative care) group (n = 39). The surgical outcomes of the three groups were compared operation time, intraoperative blood loss, variations in postoperative hemoglobin, postoperative walking time, postoperative flatus expelling time, postoperative hospital stay, and visual analog scale (VAS) scores at 6 and 12 h following surgery. Results The ERAS group recovered the quickest in terms of postoperative walking time and flatus expelling duration. The ERAS group also recovered the shortest postoperative hospital stay (3.85 ± 1.14 days), which differed significantly from that in the Conventional-Multi group, but not significantly from that in the Conventional-SPLS group. In terms of VAS scores at 6 and 12 h after surgery, the ERAS group had the lowest pain intensity, which differed significantly from that of the other two groups. The effect of surgical procedures or postoperative care on hospital stay was assessed using multiple regression analysis. The results demonstrated that ERAS was an important independent contributor to reducing postoperative hospital stay (β = 0.270, p = 0.002), while single-port surgery did not affect this index (β = 0.107, p = 0.278). Conclusion In laparoscopic myomectomy, perioperative ERAS management could control postoperative pain and shorten hospital stay. Single-port surgery could speed up the recovery of gastrointestinal function and postoperative walking time, but it did not affect postoperative pain management or the length of hospital stay. Thus, the most effective approach to improving postoperative outcomes in laparoscopic myomectomy was the application of perioperative ERAS management.
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spelling doaj.art-2f1b1a8d83e94392895633becaabb1512023-08-06T11:23:49ZengBMCBMC Women's Health1472-68742023-08-012311710.1186/s12905-023-02550-6Application of single-port procedure and ERAS management in the laparoscopic myomectomyJing Wang0Xiaomin Xu1Jingui Xu2Department of Gynecology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s HospitalDepartment of Gynecology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s HospitalDepartment of Gynecology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s HospitalAbstract Objective Advances in surgical techniques and perioperative management are the two major contributing factors to improved surgical outcomes. The purpose of the current study was to compare the efficacy of single-port surgery and perioperative enhanced recovery after surgery (ERAS) management in laparoscopic myomectomy. Methods The present study included 120 patients undergoing laparoscopic myomectomy in the Gynecological Ward of Quzhou Affiliated Hospital of Wenzhou Medical University. According to the traditional perioperative management mode and ERAS management, multi-port and single-port procedures, all patients were assigned to the Conventional-SPLS (Single-Port Laparoscopic Surgery with conventional perioperative care) group (n = 34), Conventional-Multi (multi-port laparoscopic surgery with conventional perioperative care) group (n = 47), and ERAS (multi-port laparoscopic surgery with ERAS perioperative care) group (n = 39). The surgical outcomes of the three groups were compared operation time, intraoperative blood loss, variations in postoperative hemoglobin, postoperative walking time, postoperative flatus expelling time, postoperative hospital stay, and visual analog scale (VAS) scores at 6 and 12 h following surgery. Results The ERAS group recovered the quickest in terms of postoperative walking time and flatus expelling duration. The ERAS group also recovered the shortest postoperative hospital stay (3.85 ± 1.14 days), which differed significantly from that in the Conventional-Multi group, but not significantly from that in the Conventional-SPLS group. In terms of VAS scores at 6 and 12 h after surgery, the ERAS group had the lowest pain intensity, which differed significantly from that of the other two groups. The effect of surgical procedures or postoperative care on hospital stay was assessed using multiple regression analysis. The results demonstrated that ERAS was an important independent contributor to reducing postoperative hospital stay (β = 0.270, p = 0.002), while single-port surgery did not affect this index (β = 0.107, p = 0.278). Conclusion In laparoscopic myomectomy, perioperative ERAS management could control postoperative pain and shorten hospital stay. Single-port surgery could speed up the recovery of gastrointestinal function and postoperative walking time, but it did not affect postoperative pain management or the length of hospital stay. Thus, the most effective approach to improving postoperative outcomes in laparoscopic myomectomy was the application of perioperative ERAS management.https://doi.org/10.1186/s12905-023-02550-6Enhanced recovery after surgeryLaparoscopyMyomectomy
spellingShingle Jing Wang
Xiaomin Xu
Jingui Xu
Application of single-port procedure and ERAS management in the laparoscopic myomectomy
BMC Women's Health
Enhanced recovery after surgery
Laparoscopy
Myomectomy
title Application of single-port procedure and ERAS management in the laparoscopic myomectomy
title_full Application of single-port procedure and ERAS management in the laparoscopic myomectomy
title_fullStr Application of single-port procedure and ERAS management in the laparoscopic myomectomy
title_full_unstemmed Application of single-port procedure and ERAS management in the laparoscopic myomectomy
title_short Application of single-port procedure and ERAS management in the laparoscopic myomectomy
title_sort application of single port procedure and eras management in the laparoscopic myomectomy
topic Enhanced recovery after surgery
Laparoscopy
Myomectomy
url https://doi.org/10.1186/s12905-023-02550-6
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AT xiaominxu applicationofsingleportprocedureanderasmanagementinthelaparoscopicmyomectomy
AT jinguixu applicationofsingleportprocedureanderasmanagementinthelaparoscopicmyomectomy