Zheng Mingwei, Qin Mingfang, Zhao Hongzhi
Tianjin Medical University, Tianjin, China.
Minim Invasive Ther Allied Technol. 2012 Mar;21(2):113-7. doi: 10.3109/13645706.2011.577787. Epub 2011 May 16.
This study reports the initial experience with laparoendoscopic single-site (LESS) cholecystectomy and compares it with laparoscopic cholecystectomy (LC) through a randomized controlled trial. Sixty selective patients diagnosed with cholelithiasis or polyp lesion of the gallbladder (PLG) were randomly divided into two groups undergoing either LESS cholecystectomy or LC separately. The clinical data about operations and recovery of the two groups were compared. In the LESS group 28 of 30 patients underwent LESS cholecystectomy successfully and the remaining two (6.7%) were converted to standard laparoscopic surgery. LC was successfully performed in all patients in the control group. Mean operative time of LESS cholecystectomy group and LC group was 55.6 ± 25.7 versus 42.7 ± 18.6 (p < 0.05). Mean postoperative hospital stay was 3.7 ± 1.3 versus 3.8 ± 0.8 days (p < 0.05). Mean pain index was 2.8 ± 0.6 versus 3.7 ± 1.1 (p < 0.05). A questionnaire revealed that the mean scores of satisfaction with the operation were 8.9 ± 0.7 versus 8.1 ± 1.5 (p < 0.05). LESS cholecystectomy is safe, feasible, minimally invasive, and cosmetic. It is a reasonable alternative to selective patients with uncomplicated cholelithiasis and PLG. But larger controlled studies are still needed.
本研究报告了经自然腔道内镜手术（LESS）行胆囊切除术的初步经验，并通过一项随机对照试验将其与腹腔镜胆囊切除术（LC）进行比较。60例被诊断为胆囊结石或胆囊息肉样病变（PLG）的择期患者被随机分为两组，分别接受LESS胆囊切除术或LC。比较两组的手术及恢复情况的临床数据。LESS组30例患者中28例成功接受了LESS胆囊切除术，其余2例（6.7%）中转至标准腹腔镜手术。对照组所有患者均成功实施了LC。LESS胆囊切除术组和LC组的平均手术时间分别为55.6±25.7分钟和42.7±18.6分钟（p<0.05）。术后平均住院时间分别为3.7±1.3天和3.8±0.8天（p<0.05）。平均疼痛指数分别为2.8±0.6和3.7±1.1（p<0.05）。一项问卷调查显示，对手术的满意度平均得分分别为8.9±0.7和8.1±1.5（p<0.05）。LESS胆囊切除术安全、可行、微创且美观。对于患有单纯性胆囊结石和PLG的择期患者而言，它是一种合理的替代选择。但仍需要更大规模的对照研究。
