Dávila Fausto, Tsin Daniel, González Gloria, Dávila M Ruth, Lemus José, Dávila Ulises
Departamento de Cirugía Endoscopica, Hospital Regional Sesver, Poza Rica, Veracruz, México.
Departamento de Cirugía Mini Invasiva, Hospital Mount Sinai of Queens, Nueva York, Estados Unidos.
Cir Esp. 2014 Apr;92(4):261-8. doi: 10.1016/j.ciresp.2013.01.008. Epub 2013 Jun 7.
The usefulness of percutaneous needles (PN) to replace traditional assistance ports in mini-invasive techniques with a single port is analyzed and their feasibility for conducting a single port laparoscopic cholecystectomy (SPLC) is demonstrated.
A retrospective, linear and descriptive study covering 2,431 patients with a diagnosis of acute and non-acute gallbladder disease has been conducted. The patients underwent a single port laparoscopic cholecystectomy using some type of PNs, replacing the assisting ports used in traditional laparoscopic cholecystechtomy (TLC). Based on the progressive use of PNs-reins (R), hooked needles (HN) and passing suture needles (PSN)-to carry out the SPLC technique, 3 groups have been established: A, B and C. The results were compared using a Student T test, odds ratio and CI and were analyzed by means of the SPSS software v. 13.0.
The use of PNs showed an increased feasibility for the laparoscopic procedure, as they were included in the surgical technique. The R were useful when carrying out the SPLC in 78% of the cases and when the HK were added, the results increased to 88%. When using the 3 types (R, HN and PSN), the results increased by 96%. Statistical significance was obtained with these values: chi 2=67.13 and P<.001; odds ratio and 95% CI became significant when comparing the B/C, A/C, and A-B/C groups.
The PNs, replacing the assisting ports in laparoscopy, make it possible to attain a feasibility of the process in 96% of the cases. This percentage was similar to what is achieved with the TLC, which places the one port laparoscopy surgery technique as an advantageous and economic alternative. This application of the PNs could be made extensive to other single-port techniques, with a multi-valve platform and natural orifice surgery.
分析经皮穿刺针(PN)在单孔微创技术中替代传统辅助端口的实用性,并证明其用于单孔腹腔镜胆囊切除术(SPLC)的可行性。
开展一项回顾性、线性描述性研究,纳入2431例诊断为急性和非急性胆囊疾病的患者。这些患者接受了使用某种PN的单孔腹腔镜胆囊切除术,取代了传统腹腔镜胆囊切除术(TLC)中使用的辅助端口。基于逐步使用PN-缰绳(R)、钩针(HN)和穿刺缝合针(PSN)来实施SPLC技术,设立了A、B和C三组。使用学生t检验、优势比和置信区间比较结果,并通过SPSS 13.0软件进行分析。
PN的使用显示出腹腔镜手术的可行性增加,因为它们被纳入了手术技术。R在78%的SPLC病例中有用,加入HK后,结果提高到88%。使用三种类型(R、HN和PSN)时,结果提高到96%。这些值具有统计学意义:卡方=67.13,P<0.001;比较B/C、A/C和A-B/C组时,优势比和95%置信区间变得显著。
PN替代腹腔镜中的辅助端口,使得96%的病例能够实现该手术过程的可行性。这个百分比与TLC所达到的相似,这使得单孔腹腔镜手术技术成为一种有利且经济的选择。PN的这种应用可以广泛应用于其他单孔技术、多瓣膜平台以及自然腔道手术。