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单孔腹腔镜胆囊切除术的手术应激反应及临床结局:前瞻性非随机研究

Surgical stress response and clinical outcomes of single port laparoscopic cholecystectomy: prospective nonrandomized study.

作者信息

Han Hyung Joon, Choi Sae Byeol, Kim Wan Bae, Lee Jin-Suk, Boo Yoon Jung, Song Tae Jin, Suh Sung Ock, Choi Sang Yong

机构信息

Department of Surgery, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea.

出版信息

Am Surg. 2012 Apr;78(4):485-91.

Abstract

The levels of interleukin-6 (IL-6) are proportionate to injury; it is the most commonly used quantitative marker in surgical studies. Cytokines and the acute-phase response play an important role in controlling the human immune system. The objective of this study was to compare the systemic acute cytokine response and clinical outcomes of conventional laparoscopic and single port laparoscopic cholecystectomy. We compared patients who underwent single port laparoscopic cholecystectomy (the single port group) with patients who underwent conventional laparoscopic cholecystectomy (the conventional group) according to the clinical variables, IL-6, leukocyte subpopulations, and visual analog scale (VAS) pain score. The mean age in the single port group was significantly younger (P = 0.010) and the mean operation time in the conventional group was significantly shorter (P = 0.002). Postoperative 4-hour VAS pain score was slightly worse in the single port laparoscopic cholecystectomy group, but was not significantly different. We found no difference in clinical outcomes, the level of serum IL-6, C-reactive protein, leukocyte subpopulations, and complications between the two groups. Stress response in single port laparoscopic cholecystectomy is equal to conventional surgery. Postoperative 4-hour VAS pain score was slightly worse and the operation time is significantly longer in the single port laparoscopic cholecystectomy group.

摘要

白细胞介素-6(IL-6)水平与损伤程度成正比;它是外科研究中最常用的定量标志物。细胞因子和急性期反应在控制人体免疫系统中发挥着重要作用。本研究的目的是比较传统腹腔镜胆囊切除术和单孔腹腔镜胆囊切除术的全身急性细胞因子反应及临床结果。我们根据临床变量、IL-6、白细胞亚群和视觉模拟评分(VAS)疼痛评分,将接受单孔腹腔镜胆囊切除术的患者(单孔组)与接受传统腹腔镜胆囊切除术的患者(传统组)进行比较。单孔组的平均年龄显著更小(P = 0.010),传统组的平均手术时间显著更短(P = 0.002)。单孔腹腔镜胆囊切除术组术后4小时的VAS疼痛评分略差,但差异无统计学意义。我们发现两组在临床结果、血清IL-6水平、C反应蛋白、白细胞亚群及并发症方面无差异。单孔腹腔镜胆囊切除术的应激反应与传统手术相当。单孔腹腔镜胆囊切除术组术后4小时的VAS疼痛评分略差,且手术时间显著更长。

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