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在使用激光辅助透照术的胃镜-腹腔镜联合手术中,单孔与标准腹腔镜切除胃良性肿瘤的比较

Single-port versus standard laparoscopic resection for a gastric benign tumor in gastroscopic-laparoscopic rendezvous procedures using a laser-supported diaphanoscopy.

作者信息

Patrzyk Maciej, Glitsch Anne, Schreiber André, Busemann Alexandra, Partecke Lars I, Heidecke Claus D

机构信息

Department of General, Visceral, Thoracic and Vascular Surgery, Universitätsmedizin, Ernst-Moritz-Arndt-University, Greifswald, Germany.

出版信息

Surg Laparosc Endosc Percutan Tech. 2013 Aug;23(4):400-5. doi: 10.1097/SLE.0b013e31828e3fe1.

DOI:10.1097/SLE.0b013e31828e3fe1
PMID:23917596
Abstract

In this study, the standard laparoscopic technique versus the single-port approach was evaluated for the excision of benign gastric tumors using tissue-sparing laser-supported diaphanoscopy for localization. The first group consisted of 10 patients suffering from benign gastric tumors treated by standard laparoscopic resection. The second group included 10 patients treated using the single-port technique. All procedures were successfully completed. Histopathologic examination confirmed 15 cases of gastrointestinal stromal tumor, 3 cases of lipoma, 1 case of leiomyoma, and 1 case of high-grade dysplasia. There was no statistically significant difference for the operation times between both groups. Comparison of the largest and smallest resection margins achieved using the standard laparoscopic technique and single-port techniques showed no statistically significant differences between the groups. During follow-up, all patients were evaluated using the total body image and cosmesis questionnaire. Although scores of all body-image functions were similar, independent of laparoscopic technique, scores of all cosmetic functions in patients operated using the single-port technique showed a statistically significant higher degree of satisfaction with the scar (P<0185). The postoperative pain scores evaluated by the visual analog scale score were not significantly different between 2 groups. The single-port technique was found to be a feasible option for the resection of submucosal or mucosal tumors. However, this method is not intended to replace standard laparoscopic resections.

摘要

在本研究中,对使用组织保留激光辅助透照术进行定位的标准腹腔镜技术与单孔入路切除良性胃肿瘤进行了评估。第一组包括10例接受标准腹腔镜切除术治疗的良性胃肿瘤患者。第二组包括10例采用单孔技术治疗的患者。所有手术均成功完成。组织病理学检查证实有15例胃肠道间质瘤、3例脂肪瘤、1例平滑肌瘤和1例高级别上皮内瘤变。两组之间的手术时间无统计学显著差异。比较使用标准腹腔镜技术和单孔技术获得的最大和最小切缘,两组之间无统计学显著差异。在随访期间,使用全身图像和美容调查问卷对所有患者进行评估。尽管所有身体图像功能的评分相似,与腹腔镜技术无关,但采用单孔技术手术的患者所有美容功能的评分显示对瘢痕的满意度在统计学上有显著更高的程度(P<0.185)。通过视觉模拟量表评分评估的术后疼痛评分在两组之间无显著差异。发现单孔技术是切除黏膜下或黏膜肿瘤的一种可行选择。然而,该方法并非旨在取代标准腹腔镜切除术。

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