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迷你腹腔镜与传统腹腔镜胆囊切除术:一项随机对照试验。

Mini-laparoscopic versus conventional laparoscopic cholecystectomy: a randomized controlled trial.

作者信息

de Carvalho Luís Filipe Abreu, Fierens Kjell, Kint Marc

机构信息

Department of General Surgery, Sint-Lucas Hospital, Ghent, Belgium.

出版信息

J Laparoendosc Adv Surg Tech A. 2013 Feb;23(2):109-16. doi: 10.1089/lap.2012.0349. Epub 2012 Dec 31.

Abstract

BACKGROUND

Several studies have reported faster recoveries, lower pain scores, and superior cosmetic results after mini-laparoscopic cholecystectomy (MLC). The purpose of this study was to perform a randomized controlled trial, comparing MLC with conventional laparoscopic cholecystectomy (LC).

SUBJECTS AND METHODS

Forty-one patients with symptomatic cholecystolithiasis were randomized between the two groups: 23 having undergone LC and 18 MLC. The primary end point was postoperative pain, which was evaluated during the first 24 hours postoperatively, using the numerical rating scale. Patient satisfaction with the cosmetic result was evaluated after 1 month.

RESULTS

The two groups were comparable concerning age, sex, and body mass index. The median operating time (42 minutes versus 45 minutes; P=.386), complication rate, and duration of hospital stay (2 days; P=.611) were similar in both groups. The level of postoperative pain was analogous at every time. There was no difference in the analgesic requirements or cosmesis.

CONCLUSIONS

MLC showed similar results concerning postoperative pain and did not lead to a greater patient satisfaction with the cosmetic result, compared with LC. MLC did not take longer to perform, nor was it associated with major complications or a high conversion rate. MLC is a safe and feasible technique for the treatment of gallbladder disease in elective patients.

摘要

背景

多项研究报告称,小切口腹腔镜胆囊切除术(MLC)后恢复更快、疼痛评分更低且美容效果更佳。本研究的目的是进行一项随机对照试验,比较MLC与传统腹腔镜胆囊切除术(LC)。

受试者与方法

41例有症状的胆囊结石患者被随机分为两组:23例行LC,18例行MLC。主要终点是术后疼痛,术后24小时内使用数字评分量表进行评估。术后1个月评估患者对美容效果的满意度。

结果

两组在年龄、性别和体重指数方面具有可比性。两组的中位手术时间(42分钟对45分钟;P = 0.386)、并发症发生率和住院时间(2天;P = 0.611)相似。每次术后疼痛程度相似。镇痛需求和美容效果方面无差异。

结论

与LC相比,MLC在术后疼痛方面显示出相似的结果,且未使患者对美容效果更满意。MLC手术时间不会更长,也未出现重大并发症或高转换率。MLC是择期患者治疗胆囊疾病的一种安全可行的技术。

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