Lee Jieun, Lee Sung Ryol, Kim Hyung Ook, Son Byung Ho, Choi Wonjun
Department of Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ann Coloproctol. 2014 Feb;30(1):42-6. doi: 10.3393/ac.2014.30.1.42. Epub 2014 Feb 28.
A laparoscopic appendectomy is now commonly performed. The push in recent years toward reducing the number of ports required to perform this surgery has led to the development of a single-port laparoscopic appendectomy (SPA). We compared postoperative pain after an SPA using a glove port with a percutaneous organ-holding device (group 1) with that of an SPA using a commercially-available multichannel single-port device (group 2).
Between March 2010 and July 2011, a retrospective study was conducted of a total of 77 patients who underwent an SPA by three surgeons at department of surgery, Kangbuk Samsung Medical Center. Thirty-eight patients received an SPA using a glove port with a percutaneous organ-holding device. The other 39 patients received an SPA using a commercially-available multichannel single port (Octo-Port or SILS Port). Operative details and postoperative outcomes were collected and evaluated.
There were no differences in the mean operative times, times to pass gas, postoperative hospital stays, or cosmetic satisfaction scores between the two groups. The pain score in the first 24 hours after surgery was higher in group 2 than group 1 patients (P < 0.001). Furthermore, the trocar used in group 2 was more expensive than that used in group 1.
An SPA using a glove port with a percutaneous organ-holding device was associated with a lower pain score during the first 24 hours after surgery because of the shorter fascia incision length and a cheaper cost than an SPA using a commercially-available multichannel single-port device.
目前腹腔镜阑尾切除术已普遍开展。近年来,减少该手术所需切口数量的趋势促使单孔腹腔镜阑尾切除术(SPA)得以发展。我们比较了使用带经皮器官固定装置的手套式切口进行单孔腹腔镜阑尾切除术(第1组)与使用市售多通道单孔装置进行单孔腹腔镜阑尾切除术(第2组)后的术后疼痛情况。
2010年3月至2011年7月,对江原三星医疗中心外科的三位外科医生实施的77例单孔腹腔镜阑尾切除术患者进行了回顾性研究。38例患者使用带经皮器官固定装置的手套式切口进行单孔腹腔镜阑尾切除术。另外39例患者使用市售多通道单孔装置(Octo-Port或SILS Port)进行单孔腹腔镜阑尾切除术。收集并评估手术细节和术后结果。
两组患者的平均手术时间、排气时间、术后住院时间或美容满意度评分均无差异。术后第1个24小时,第2组患者的疼痛评分高于第1组患者(P < 0.001)。此外,第2组使用的套管针比第1组的更昂贵。
使用带经皮器官固定装置的手套式切口进行单孔腹腔镜阑尾切除术,由于筋膜切口长度较短且成本低于使用市售多通道单孔装置进行单孔腹腔镜阑尾切除术,术后第1个24小时的疼痛评分较低。