Department of Surgery, Drexel University College of Medicine, 219 North Broad Street, Philadelphia, PA 19107, USA.
Surg Endosc. 2010 Aug;24(8):1854-60. doi: 10.1007/s00464-009-0856-x. Epub 2010 Feb 5.
An important aspect of a new surgical technique is whether it can be performed by other surgeons in other institutions. The authors report the first 297 cases in a multi-institutional and multinational review of laparoscopic cholecystectomy performed via a single portal of entry.
Data were collected retrospectively for the initial patients undergoing single-port cholecystectomy by 13 surgeons who performed these procedures in their institutions after training by the authors. The review included operative time, blood loss, incision length, length of hospital stay (LOS), necessary additional trocars, and other parameters important to cholecystectomy. A database of all the single-port-access (SPA) surgeries performed by the surgeons included demographic and procedural details, LOS, complications, and initial follow-up data.
To date, 297 single-port cholecystectomies have been performed for a variety of diagnoses, primarily cholelithiasis. The average operative time was 71 min, and the average LOS was 1-2 days. The average blood loss was minimal. The use of additional port sites outside the umbilicus occurred in 34 of the cases. Of the 35 intraoperative cholangiograms performed, 34 were successful. No significant complications occurred except for seromas and minor postoperative wound infections. These results are comparable with those for standard multiport cholecystectomy. In addition, no access site hernias (ASH) occurred.
The findings demonstrate that SPA surgery is an alternative to multiport laparoscopy with fewer scars and better cosmesis. One factor affecting the rate for adoption of SPA surgery among other surgeons is the reproducibility of this new procedure. Although this study had insufficient data to determine fully the benefits of SPA surgery, the feasibility of this procedure with safe, acceptable results was demonstrated in this initial large series across multinational institutions.
新手术技术的一个重要方面是它是否可以由其他外科医生在其他机构进行。作者报告了首例通过单一入口进行腹腔镜胆囊切除术的多机构和多国回顾性研究的前 297 例。
对 13 位外科医生在作者培训后在各自机构进行的单端口胆囊切除术的初始患者进行回顾性数据收集。该研究包括手术时间、出血量、切口长度、住院时间（LOS）、必要的附加 trocars 以及对胆囊切除术很重要的其他参数。所有外科医生进行的单端口通道（SPA）手术的数据库包括人口统计学和手术细节、LOS、并发症以及初始随访数据。
迄今为止，已为各种诊断（主要是胆石症）进行了 297 例单端口胆囊切除术。平均手术时间为 71 分钟，平均 LOS 为 1-2 天。平均出血量很少。在 34 例病例中，在脐部以外使用了附加端口部位。在 35 例术中胆管造影中，有 34 例成功。除血清肿和轻微术后伤口感染外，无明显并发症。这些结果与标准多孔腹腔镜胆囊切除术相当。此外，未发生切口疝（ASH）。
这些发现表明 SPA 手术是多孔腹腔镜手术的替代方法，具有更少的疤痕和更好的美容效果。影响其他外科医生采用 SPA 手术的一个因素是这种新手术的可重复性。尽管这项研究的数据不足以完全确定 SPA 手术的益处，但在多机构的初始大型系列研究中证明了该手术的可行性和安全、可接受的结果。
