Akethong Chinda, Sawaengtham Thiti
Department of Surgery, Nakhonpathom Hospital, Nakhonpathom, Thailand.
J Med Assoc Thai. 2013 Sep;96(9):1143-6.
Laparoscopic cholecystectomy is now standard treatment of gallstone disease and has traditionally been performed using multiple small sites. Single-incision laparoscopic surgery has emerged as an alternative technique to improve cosmesis and minimize complications associated with multiple incisions pain and longer hospital stay.
Between January 2010 and December 2012, 40 patients were assigned to one of the two groups, SILS-C or conventional LC. Surgical indication, operative time, length of stay, and surgical complications were compared between the two groups.
Twenty patients underwent SILS-C and 20 patients underwent conventional three ports LC. The average length of stay was 2.60 +/- 0.88 days after SILS-C compared with 2.65 +/- 0.87 days after CLC (p = 0.871). Operative time was significantly longer in the SILS-C group. An average of 65 minutes was needed to complete a SILS-C (range 35-141) versus 51 minutes (range 24-109) for a CLC (p < 0.001). There was no difference in pain score and complications between both groups but SILS-C group use less analgesic (81.00 +/- 36.55 mg in SILS-C vs. 123.00 +/- 42.31 mg in the conventional group).
The Single Incision Laparoscopic Cholecystectomy (SILS-C) is feasible and safe. The results of SILS-C were comparable with the standard conventional LC.
腹腔镜胆囊切除术现已成为胆结石疾病的标准治疗方法，传统上是通过多个小切口进行的。单切口腹腔镜手术已成为一种替代技术，以改善美观并最大限度地减少与多个切口相关的疼痛和更长住院时间的并发症。
2010年1月至2012年12月期间，40例患者被分配到两组之一，即单切口腹腔镜胆囊切除术组（SILS-C）或传统腹腔镜胆囊切除术组（LC）。比较两组的手术适应症、手术时间、住院时间和手术并发症。
20例患者接受了SILS-C手术，20例患者接受了传统三孔LC手术。SILS-C术后平均住院时间为2.60±0.88天，而传统LC术后为2.65±0.87天（p = 0.871）。SILS-C组的手术时间明显更长。完成一例SILS-C平均需要65分钟（范围35 - 141分钟），而传统LC手术平均需要51分钟（范围24 - 109分钟）（p < 0.001）。两组之间的疼痛评分和并发症没有差异，但SILS-C组使用的镇痛药较少（SILS-C组为81.00±36.55毫克，传统组为123.00±42.31毫克）。
单切口腹腔镜胆囊切除术（SILS-C）是可行且安全的。SILS-C的结果与标准传统LC相当。
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