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单孔腹腔镜胆囊切除术与传统四孔腹腔镜胆囊切除术的前瞻性随机对照研究。

Prospective randomized comparative study of single incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy.

机构信息

Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Rd., Chai Wan, Hong Kong SAR, China.

出版信息

Am J Surg. 2011 Sep;202(3):254-8. doi: 10.1016/j.amjsurg.2010.12.009.

Abstract

BACKGROUND

This study aimed to compare the outcomes of single-incision laparoscopic cholecystectomy (SILC) versus conventional 4-port laparoscopic cholecystectomy (LC).

METHODS

From November 2009 to August 2010, 51 patients with symptomatic gallstone or gallbladder polyps were randomized to SILC (n = 24) or 4-port LC (n = 27).

RESULTS

Mean surgical time (43.5 vs 46.5 min), median blood loss (1 vs 1 mL) and mean hospital stay (1.5 vs 1.8 d) were similar for both the SILC and 4-port LC group. There were no open conversions and no major complications. The mean total wound length of the SILC group was significantly shorter (1.76 vs 2.25 cm). The median visual analogue pain score at 6 hours after surgery was similar (4.5 vs 4.0) but the SILC group had a significantly worse pain score on day 7 (1 vs 0). There was no difference in time to resume usual activity (mean, 5.6 vs 5.0 d). The median cosmetic score of SILC was significantly higher than at 3 months after surgery (7 vs 6).

CONCLUSIONS

SILC was feasible and safe for properly selected patients in experienced hands.

摘要

背景

本研究旨在比较单切口腹腔镜胆囊切除术(SILC)与传统四孔腹腔镜胆囊切除术(LC)的治疗效果。

方法

2009 年 11 月至 2010 年 8 月,51 例有症状的胆囊结石或胆囊息肉患者随机分为 SILC 组(n=24)和 4 孔 LC 组(n=27)。

结果

SILC 组和 4 孔 LC 组的平均手术时间(43.5 分钟 vs 46.5 分钟)、中位出血量(1 毫升 vs 1 毫升)和平均住院时间(1.5 天 vs 1.8 天)相似。两组均无中转开腹,无严重并发症。SILC 组的总切口长度明显更短(1.76 厘米 vs 2.25 厘米)。术后 6 小时的中位视觉模拟疼痛评分相似(4.5 分 vs 4.0 分),但 SILC 组术后第 7 天的疼痛评分明显更差(1 分 vs 0 分)。两组恢复日常活动的时间无差异(平均 5.6 天 vs 5.0 天)。SILC 的中位美容评分明显高于术后 3 个月(7 分 vs 6 分)。

结论

对于经验丰富的外科医生,SILC 对于合适的患者是可行和安全的。

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