Chow Andre, Purkayastha Sanjay, Aziz Omer, Pefanis Dina, Paraskeva Paraskevas
Department of Biosurgery and Surgical Technology, Imperial College London, England.
Arch Surg. 2010 Dec;145(12):1187-91. doi: 10.1001/archsurg.2010.267.
To report our experience with single-incision laparoscopic surgery (SILS) for cholecystectomy and to perform a retrospective comparison with conventional 4-port laparoscopic cholecystectomy.
DESIGN, SETTING, AND PATIENTS: Data were prospectively collected for all patients undergoing SILS for cholecystectomy at St Mary's Hospital, Imperial College NHS Trust, London, England (n = 41 patients between June 13, 2008, and June 30, 2009) and compared with data for those who had undergone conventional 4-port laparoscopic cholecystectomy in the preceding year (n = 58 patients between June 26, 2007, and May 30, 2008). This included patient demographic data and intraoperative and postoperative outcomes.
Four-port laparoscopic cholecystectomy and SILS for cholecystectomy.
Operative time, conversion to open operation, and length of hospital stay.
Operative time was longer with SILS for cholecystectomy compared with conventional laparoscopic cholecystectomy (P < .001). A correlation was seen between reducing SILS operative time and increasing experience (Spearman rank correlation coefficient, -0.29). Three patients in the SILS for cholecystectomy group required the addition of extra laparoscopic ports. No patients in the SILS for cholecystectomy group required conversion to open surgery compared with 4 patients in the standard laparoscopic cholecystectomy group. Patients stayed an average of 0.76 days following SILS for cholecystectomy and 1.53 days following conventional laparoscopic cholecystectomy. One patient in each group had a postoperative biliary leak.
Single-incision laparoscopic surgery for cholecystectomy may be equal to conventional laparoscopic cholecystectomy in terms of safety and efficacy. Further randomized studies are required to investigate any significant advantages of this new and attractive technique.
报告我们单孔腹腔镜胆囊切除术的经验，并与传统四孔腹腔镜胆囊切除术进行回顾性比较。
设计、地点和患者：前瞻性收集了在英国伦敦帝国学院国民保健服务信托基金圣玛丽医院接受单孔腹腔镜胆囊切除术的所有患者的数据（2008年6月13日至2009年6月30日期间，共41例患者），并与前一年接受传统四孔腹腔镜胆囊切除术的患者数据（2007年6月26日至2008年5月30日期间，共58例患者）进行比较。这包括患者的人口统计学数据以及术中及术后结果。
四孔腹腔镜胆囊切除术和单孔腹腔镜胆囊切除术。
手术时间、中转开腹手术情况以及住院时间。
与传统腹腔镜胆囊切除术相比，单孔腹腔镜胆囊切除术的手术时间更长（P < 0.001）。单孔腹腔镜胆囊切除术手术时间的缩短与经验的增加之间存在相关性（斯皮尔曼等级相关系数为 -0.29）。单孔腹腔镜胆囊切除术组中有3例患者需要增加额外的腹腔镜端口。单孔腹腔镜胆囊切除术组中无患者需要中转开腹手术，而标准腹腔镜胆囊切除术组中有4例患者需要中转开腹手术。单孔腹腔镜胆囊切除术后患者平均住院0.76天，传统腹腔镜胆囊切除术后患者平均住院1.53天。每组各有1例患者发生术后胆漏。
单孔腹腔镜胆囊切除术在安全性和有效性方面可能与传统腹腔镜胆囊切除术相当。需要进一步进行随机研究以探讨这种新的且有吸引力的技术的任何显著优势。
