Jiang Ze-sheng, Cheng Yuan, Xu Xiao-ping, Zhang Zhi, He Guo-lin, Xu Ting-cheng, Zhou Chen-jie, Qin Jia-sheng, Liu Hai-yan, Gao Yi, Pan Ming-xin
Department of Hepatobiliary Surgery, Southern Medical University, Guangzhou, China.
Zhonghua Yi Xue Za Zhi. 2013 Feb 5;93(6):455-8.
To compare the operative techniques of single-incision laparoscopic cholecystectomy (SILC) via suture-suspension versus three-device method.
Retrospective analysis was performed for a total of 300 patients undergoing umbilical single-incision laparoscopic cholecystectomy from June 2008 to November 2011 at our hospital. The procedures were of suture-suspension (n = 200) and three-device (n = 100). Operative duration, estimated intra-operative blood loss, exposure extent of Calot's triangle, postoperative pain score, hospital stay and complications were compared respectively between two groups. Both groups were matched for age, gender, body mass index (BMI), diagnoses and American Society of Anesthesiology (ASA) class.
All procedures were completed by the same surgeon. Comparison between two groups showed insignificant differences in blood loss (mean: (15.6 ± 9.5) vs (16.8 ± 7.4) ml; t = 1.266, P = 0.207), postoperative complications (number of case, incision contusion:4 vs 2, P = 1.000;incision hemorrhage:2 vs 2, P = 0.603) and hospitalization duration (mean: (1.6 ± 0.5) vs (1.6 ± 0.5) d; t = 0.653, P = 0.514), but significant differences in operative duration (mean:(40.5 ± 16.0) vs (51.5 ± 18.0) min; t = 5.381, P = 0.000), postoperative pain (mean: 2.0 ± 1.7 vs 3.7 ± 1.6; t = 8.324, P = 0.000) and exposure of Calot's triangle (number of case, 197 vs 68; χ(2) = 60.178, P = 0.000). Thus the suture-suspension method was superior to the three-device counterpart.
The suture-suspension method of SILC is safe, economic and easy-to-handle in clinical practice.
比较缝线悬吊法与三器械法单孔腹腔镜胆囊切除术(SILC)的手术技巧。
对2008年6月至2011年11月在我院接受脐部单孔腹腔镜胆囊切除术的300例患者进行回顾性分析。手术方法为缝线悬吊法(n = 200)和三器械法(n = 100)。分别比较两组患者的手术时间、估计术中出血量、胆囊三角暴露范围、术后疼痛评分、住院时间及并发症情况。两组患者在年龄、性别、体重指数(BMI)、诊断及美国麻醉医师协会(ASA)分级方面相匹配。
所有手术均由同一外科医生完成。两组比较,出血量(均值:(15.6 ± 9.5) vs (16.8 ± 7.4) ml;t = 1.266,P = 0.207)、术后并发症(例数,切口挫伤:4 vs 2,P = 1.000;切口出血:2 vs 2,P = 0.603)及住院时间(均值:(1.6 ± 0.5) vs (1.6 ± 0.5) d;t = 0.653,P = 0.514)差异无统计学意义,但手术时间(均值:(40.5 ± 16.0) vs (51.5 ± 18.0) min;t = 5.381,P = 0.000)、术后疼痛(均值:2.0 ± 1.7 vs 3.7 ± 1.6;t = 8.324,P = 0.000)及胆囊三角暴露情况(例数,197 vs 68;χ(2) = 60.178,P = 0.000)差异有统计学意义。因此,缝线悬吊法优于三器械法。
SILC的缝线悬吊法在临床实践中安全、经济且易于操作。