Inoue Shogo, Ikeda Kenichiro, Kobayashi Kanao, Kajiwara Mitsuru, Teishima Jun, Matsubara Akio
Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
Can Urol Assoc J. 2014 Jan-Feb;8(1-2):E20-5. doi: 10.5489/cuaj.1543.
We evaluate patient-reported satisfaction and cosmesis of laparoendoscopic single-site adrenalectomy (LESS-A) in comparison with that of conventional laparoscopic adrenalectomy (CLA).
A total of 19 and 104 patients who respectively underwent LESS-A and CLA between May 1996 and June 2011 were included in the study. Questionnaires inquiring about scar pain (0: not painful, 10: very painful), satisfaction (0: not satisfied, 10: very satisfied) and cosmesis (0: very unsightly, 10: very beautiful) on the basis of a visual analogue scale were sent to patients postoperatively.
The respondents consisted of 11 and 54 patients who underwent LESS-A and CLA, respectively. There was no significant inter-group difference in age, sex, affected side or body mass index. No significant differences were observed in operative time or estimated blood loss. There were also no significant differences in pain (0.67 vs. 0.57, p = 0.393), satisfaction (8.92 vs. 8.46, p = 0.453), or cosmesis score (8.58 vs. 8.00, p = 0.487) between the LESS-A and CLA groups overall. In female patients, the satisfaction score was significantly higher in the LESS-A group than in the CLA group (10.0 vs. 8.72, p = 0.049). In young patients (<50 years old), the satisfaction score was also significantly higher in the LESS-A group than in the CLA group (9.17 vs. 6.38, p = 0.036).
Young patients and female patients who had received LESS-A adrenal surgery were more satisfied with the scar outcomes than were the young patients and female patients who had received CLA. We suggest that this patient subset most values the cosmetic benefits of LESS-A.
我们评估了经腹腔镜单孔肾上腺切除术(LESS - A)与传统腹腔镜肾上腺切除术(CLA)相比患者报告的满意度和美容效果。
1996年5月至2011年6月期间分别接受LESS - A和CLA手术的19例和104例患者纳入本研究。术后向患者发送基于视觉模拟量表询问疤痕疼痛(0:无痛,10:非常疼痛)、满意度(0:不满意,10:非常满意)和美容效果(0:非常难看,10:非常美观)的问卷。
分别有11例和54例接受LESS - A和CLA手术的患者回复了问卷。两组在年龄、性别、患侧或体重指数方面无显著组间差异。手术时间或估计失血量也无显著差异。总体而言,LESS - A组和CLA组在疼痛(0.67对0.57,p = 0.393)、满意度(8.92对8.46,p = 0.453)或美容评分(8.58对8.00,p = 0.487)方面也无显著差异。在女性患者中,LESS - A组的满意度评分显著高于CLA组(10.0对8.72,p = 0.049)。在年轻患者(<50岁)中,LESS - A组的满意度评分也显著高于CLA组(9.17对6.38,p = 0.036)。
接受LESS - A肾上腺手术的年轻患者和女性患者对疤痕效果比接受CLA手术的年轻患者和女性患者更满意。我们认为这部分患者最看重LESS - A的美容益处。