Department of General Surgery, Faculty of Medicine, University of Istanbul, Istanbul, Turkey.
Surg Endosc. 2012 Jan;26(1):36-40. doi: 10.1007/s00464-011-1824-9. Epub 2011 Jul 15.
The aim of this study was to compare outcome measures between conventional transabdominal laparoscopic adrenalectomy and single-incision laparoscopic adrenalectomy (SILA).
Between January 2006 and April 2010, a total of 96 patients underwent laparoscopic adrenalectomy. Of these, 74 (77.1%) underwent conventional transabdominal laparoscopic adrenalectomy (group 1) and 22 (32.9%) underwent SILA (group 2). Age, sex ratio, tumor size, operating time, blood loss, postoperative visual analog pain scale (VAS) scores, and duration of hospitalization were compared between the two groups.
The mean ages of the patients in groups 1 and 2 were 43.4 ± 12.3 and 43.3 ± 10 years, respectively (P = 0.7). The female:male ratios in groups 1 and 2 were 1.6:1 and 4.5:1, respectively (P < 0.0001). The mean tumor size was significantly larger in group 1 than in group 2 (4.7 ± 1.5 vs. 3.34 ± 1.06 cm, respectively; P = 0.093). No significant difference was found between group 1 and group 2 with respect to the mean operating time (68.4 ± 20.8 vs. 63.9 ± 16.9 min, respectively; P = 0.36) or the level of intraoperative blood loss (38 ± 26.5 vs. 48.4 ± 62.4 ml, respectively; P = 0.26). The postoperative VAS score was significantly lower in group 2 than in group 1 (2.05 ± 0.57 and 3.28 ± 0.63, respectively; P < 0.0001). The length of hospital stay was significantly higher in group 1 than in group 2 (3.04 ± 1.2 and 2.45 ± 0.96 days, respectively; P = 0.04).
The findings of the present study suggest that SILA is as safe as conventional transabdominal laparoscopic adrenalectomy. Furthermore, SILA is associated with less pain and better cosmesis than the conventional laparoscopic procedure.
本研究旨在比较传统经腹腹腔镜肾上腺切除术和单切口腹腔镜肾上腺切除术（SILA）之间的手术结果。
2006 年 1 月至 2010 年 4 月期间，共有 96 例患者接受了腹腔镜肾上腺切除术。其中，74 例（77.1%）接受了传统经腹腹腔镜肾上腺切除术（第 1 组），22 例（32.9%）接受了 SILA（第 2 组）。比较两组患者的年龄、性别比例、肿瘤大小、手术时间、出血量、术后视觉模拟疼痛评分（VAS）和住院时间。
第 1 组和第 2 组患者的平均年龄分别为 43.4±12.3 岁和 43.3±10 岁（P=0.7）。第 1 组和第 2 组的男女比例分别为 1.6:1 和 4.5:1（P<0.0001）。第 1 组的肿瘤平均大小明显大于第 2 组（4.7±1.5 厘米与 3.34±1.06 厘米，P=0.093）。第 1 组和第 2 组的手术时间（68.4±20.8 分钟与 63.9±16.9 分钟，P=0.36）或术中出血量（38±26.5 毫升与 48.4±62.4 毫升，P=0.26）均无显著差异。第 2 组患者术后 VAS 评分明显低于第 1 组（2.05±0.57 分与 3.28±0.63 分，P<0.0001）。第 1 组患者的住院时间明显长于第 2 组（3.04±1.2 天与 2.45±0.96 天，P=0.04）。
本研究结果表明，SILA 与传统经腹腹腔镜肾上腺切除术一样安全。此外，与传统腹腔镜手术相比，SILA 术后疼痛更少，美容效果更好。
