Hosono Shunsuke, Osaka Hirohisa
Department of Surgery, Yamamoto First Hospital, Osaka, Japan.
J Laparoendosc Adv Surg Tech A. 2007 Apr;17(2):191-9. doi: 10.1089/lap.2006.0051.
We evaluated reports of minilaparoscopic cholecystectomy as compared to conventional laparoscopic cholecystectomy.
We searched the Medline, Embase, and Cochrane library databases for randomized controlled trials reported between January 1996 to December 2005. The outcome measures used were operative time, length of hospital stay, postoperative pain, postoperative analgesic requirement, and cosmetic results. Meta-analysis methods were used to measure the pooled estimate of the effect size.
Data from 712 patients (352 minilaparoscopic cholecystectomy and 360 conventional laparoscopic cholecystectomy) in 12 randomized controlled trials were analyzed. The statistically significant advantages of minilaparoscopic cholecystectomy were less postoperative pain and better cosmesis. Conventional laparoscopic cholecystectomy showed a trend to shorter operative time that did not reach statistical significance.
Minilaparoscopic cholecystectomy could be a feasible alternative to conventional laparoscopic cholecystectomy in select patients, resulting in less pain and better cosmetic results. Additional well-designed randomized controlled and, if possible, blinded trials, with large sample sizes, are required to confirm this conclusion.
我们评估了迷你腹腔镜胆囊切除术与传统腹腔镜胆囊切除术的相关报告。
我们在Medline、Embase和Cochrane图书馆数据库中检索了1996年1月至2005年12月期间报道的随机对照试验。所使用的结局指标包括手术时间、住院时间、术后疼痛、术后镇痛需求和美容效果。采用荟萃分析方法来衡量效应大小的合并估计值。
分析了12项随机对照试验中712例患者（352例行迷你腹腔镜胆囊切除术，360例行传统腹腔镜胆囊切除术）的数据。迷你腹腔镜胆囊切除术在统计学上的显著优势是术后疼痛较轻且美容效果更好。传统腹腔镜胆囊切除术显示出手术时间较短的趋势，但未达到统计学显著性。
对于部分患者，迷你腹腔镜胆囊切除术可能是传统腹腔镜胆囊切除术的一种可行替代方法，可减少疼痛并获得更好的美容效果。需要更多设计良好的随机对照试验，若可能进行盲法试验且样本量较大，以证实这一结论。
