Borle Firoz R, Mehra Bhupendra K, Jain Sheelchand
Department of General Surgery, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India.
Asian J Endosc Surg. 2014 Jan;7(1):38-42. doi: 10.1111/ases.12071. Epub 2013 Nov 13.
Single-incision laparoscopic cholecystectomy (SILC) is considered to be less invasive and have less morbidity than conventional laparoscopic cholecystectomy (CLC). However, there is a relative paucity of data regarding postoperative pain scores in rural Indian populations following SILC. Also, data pertaining to the applicability of SILC in rural Indian population are scant.
In the present randomized control trial, pain scores after SILC and CLC were evaluated. Sixty patients with gallstone disease were randomly assigned to one of two groups with 30 patients each: the CLC group and the SILC group. Postoperative pain scores were recorded on the visual analog scale at 8 hours, 24 hours and 7 days after surgery.
The patients were comparable with respect to age, sex and BMI. Operative time was longer for the SILC group (47.73 ± 5.57 min vs 69.53 ± 8.96 min; P < 0.0001).The pain scores were similar in both groups at 8 hours (3.61 ± 0.41 vs 3.50 ± 0.51; P = 0.36) and 24 hours (3.30 ± 0.59 vs 3.20 ± 0.40; P = 0.44) postoperatively. On day 7, the SILC group had lower pain scores than the CLC group (2.56 ± 0.56 vs 1.16 ± 0.37; P < 0.01).
There was no distinct advantage to SILC with regard to immediate postoperative pain. Pain was significantly less (P < 0.01) in the SILC group on postoperative day 7.
单孔腹腔镜胆囊切除术(SILC)被认为比传统腹腔镜胆囊切除术(CLC)的侵入性更小且发病率更低。然而,关于印度农村人群接受SILC术后疼痛评分的数据相对较少。此外,关于SILC在印度农村人群中的适用性的数据也很少。
在本随机对照试验中,评估了SILC和CLC术后的疼痛评分。60例胆结石疾病患者被随机分为两组,每组30例:CLC组和SILC组。术后8小时、24小时和7天采用视觉模拟量表记录疼痛评分。
两组患者在年龄、性别和体重指数方面具有可比性。SILC组的手术时间更长(47.73±5.57分钟对69.53±8.96分钟;P<0.0001)。术后8小时(3.61±0.41对3.50±0.51;P=0.36)和24小时(3.30±0.59对3.20±0.40;P=0.44)两组的疼痛评分相似。在第7天,SILC组的疼痛评分低于CLC组(2.56±0.56对1.16±0.37;P<0.01)。
SILC在术后即刻疼痛方面没有明显优势。SILC组在术后第7天的疼痛明显减轻(P<0.01)。