Hao Wei, Chan Ivy H Y, Liu Xuelai, Tang Paula M Y, Tam Paul K H, Wong Kenneth K Y
Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong SAR, China.
Pediatr Surg Int. 2012 Mar;28(3):281-6. doi: 10.1007/s00383-011-3011-4. Epub 2011 Oct 13.
Laparoendoscopic single-site surgery has recently been described in children and regarded as an improved technology leading to less pain and better cosmetic outcome. Compared to the traditional three-port method, it is not known if the single-port method is less invasive. The aim of this study was thus to investigate the post-operative acute inflammatory response in order to evaluate surgical stress in the two surgical approaches in children.
A prospective, single blinded, case-control study was carried out. Thirteen male patients who presented with unilateral varicocele were divided into two groups. Six children underwent single-port laparoscopic procedure, while the other seven children underwent three-port laparoscopic procedure. Pre-operative and post-operative blood samples were taken for the measurement of tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6) using ELISA. Demographics including the operation time, and complications were recorded. Data between the two groups were analyzed using unpaired t-test and a p value of <0.05 was taken as statistically significant.
The mean age of patients was 14.5 years (range 12-19 years). There was no significant difference between the two groups in terms of operative time, nor there was any complication recorded. The change in serum TNF-α and IL-6 concentrations pre- and post-operatively between the single-port group and three-port group was not statistically significant. Overall, patients in the two groups showed excellent satisfaction in terms of post-operative cosmesis.
Single-port laparoscopic varicocelectomy is safe, effective and produces excellent cosmesis with minimal surgical stress.
近期已有关于小儿腹腔镜单孔手术的报道，该技术被认为是一种改良技术，可减轻疼痛并获得更好的美容效果。与传统三孔法相比，单孔法是否创伤更小尚不清楚。因此，本研究旨在通过调查术后急性炎症反应，以评估两种手术方式对小儿的手术应激情况。
开展一项前瞻性、单盲、病例对照研究。13例单侧精索静脉曲张男性患者被分为两组。6例患儿接受单孔腹腔镜手术，另外7例患儿接受三孔腹腔镜手术。术前和术后采集血样，采用酶联免疫吸附测定法（ELISA）检测肿瘤坏死因子-α（TNF-α）和白细胞介素6（IL-6）。记录包括手术时间和并发症在内的人口统计学数据。两组间的数据采用成组t检验进行分析，p值<0.05被视为具有统计学意义。
患者的平均年龄为14.5岁（范围12 - 19岁）。两组在手术时间方面无显著差异，也未记录到任何并发症。单孔组和三孔组术前和术后血清TNF-α和IL-6浓度的变化无统计学意义。总体而言，两组患者对术后美容效果均表示高度满意。
单孔腹腔镜精索静脉高位结扎术安全、有效，手术应激极小，美容效果极佳。
