Daly Shaun C, Hooper Elizabeth A, Rinewalt Daniel, Myers Jonathan A, Millikan Keith W, Luu Minh
Departments of General Surgery, Rush University Medical Center, 1635 West Harrison, Chicago, IL 60612, USA.
JSLS. 2013 Jul-Sep;17(3):361-4. doi: 10.4293/108680813X13693422521791.
As attending surgeons' comfort with single-incision laparoscopic surgery (SILS) grows, and with continued improvement in surgical instruments, advanced laparoscopic techniques are increasingly being incorporated into surgical training. The aim of our study was to evaluate resident performance and patient outcomes in patients undergoing resident-performed SILS versus a resident-performed traditional laparoscopic cholecystectomy (LC).
A retrospective case-control study of 80 patients undergoing elective surgical intervention with a resident-performed SILS (n = 20) or a resident-performed traditional LC (n = 60) for gallbladder disease over a 15-month period was performed. Surgical indications, common perioperative variables, complications, and length of stay were reviewed, and all variables were evaluated for statistical significance.
Median operative times were similar for the resident-performed SILS cohort and the resident-performed traditional LC cohort (70.0 minutes and 66.0 minutes, respectively; P = .54). There were no complications in either the resident-performed SILS or resident-performed traditional LC groups. There was no difference in mean length of hospital stay between the resident-performed SILS group and resident-performed traditional LC group (0.95 days and 1.10 days, respectively; P = .50).
Our data strongly support the ability to train senior residents to complete a SILS technique safely and with the same efficacy as with traditional LC.
随着主刀外科医生对单切口腹腔镜手术（SILS）的操作越来越熟练，并且手术器械不断改进，先进的腹腔镜技术越来越多地被纳入外科培训中。我们研究的目的是评估由住院医师实施的SILS手术与由住院医师实施的传统腹腔镜胆囊切除术（LC）的患者中住院医师的操作表现和患者预后。
进行了一项回顾性病例对照研究，研究对象为80例在15个月期间因胆囊疾病接受由住院医师实施的SILS手术（n = 20）或由住院医师实施的传统LC手术（n = 60）的择期手术干预的患者。回顾了手术指征、常见围手术期变量、并发症和住院时间，并对所有变量进行统计学意义评估。
由住院医师实施的SILS队列和由住院医师实施的传统LC队列的中位手术时间相似（分别为70.0分钟和66.0分钟；P = 0.54）。由住院医师实施的SILS组和由住院医师实施的传统LC组均未出现并发症。由住院医师实施的SILS组和由住院医师实施的传统LC组之间的平均住院时间无差异（分别为0.95天和1.10天；P = 0.50）。
我们的数据有力地支持了培训高年级住院医师安全完成SILS技术并达到与传统LC相同疗效的能力。
