Emre Telciler K, Ilhan E, Yakan S, Cengiz F, Senlikci A, Aktürk Hayat E
Izmir Bozyaka Educational and Research Hospital General Surgery, Izmir, Turkey -
Minerva Chir. 2014 Feb;69(1):1-7.
The objectives of this prospective study were to compare the advantages of single-port laparoscopic cholecystectomy (SPLC) versus the classical four-port laparoscopic cholecystectomy (CLC) and to discuss these advantages in the light of current literature.
Forty eligible patients were randomized to receive SPLC (Group A, N.=20) and CLC (Group B, N.=20), and investigated with regard to age, sex, BMI (body mass index), ASA (American Society of Anesthesiologists) score, type of surgery, operative time, per-operative complication, indication for conversion to open surgery, indication for additional trocar placement in SPLC technique, post-operative pain score, additional narcotic analgesic requirement, nausea and vomiting, post-operative complication and length of hospital stay. Visual analogue scale (VAS) was used for pain scoring in all cases.
No significant difference was found among patients in Group A and Group B in terms of age, sex, weight/BMI, ASA score, VAS scores, additional analgesic requirement and length of hospital stay (P>0.05). On the other hand, mean operative time in Group A was significantly (P<0.005) greater than that in Group B. Mean operative time in Group A was observed to be reduced after the first 10 operations. Conversion to open surgery was not required in any of the patients; however, additional trocar placement was required in two patients in Group A due to body habitus and adhesions, and operations were completed laparoscopically.
We conclude that SPLC is equally effective as CLC. Patient comfort is increased and pain is decreased as the surgeon gets experienced with the technique.
本前瞻性研究的目的是比较单孔腹腔镜胆囊切除术（SPLC）与传统四孔腹腔镜胆囊切除术（CLC）的优势，并结合当前文献讨论这些优势。
将40例符合条件的患者随机分为接受SPLC组（A组，N = 20）和CLC组（B组，N = 20），并对其年龄、性别、体重指数（BMI）、美国麻醉医师协会（ASA）评分、手术类型、手术时间、术中并发症、转为开放手术的指征、SPLC技术中额外套管针置入的指征、术后疼痛评分、额外麻醉性镇痛药的需求、恶心和呕吐、术后并发症及住院时间进行调查。所有病例均采用视觉模拟量表（VAS）进行疼痛评分。
A组和B组患者在年龄、性别、体重/体重指数、ASA评分、VAS评分、额外镇痛药需求及住院时间方面无显著差异（P>0.05）。另一方面，A组的平均手术时间显著长于B组（P<0.005）。在最初的10例手术后，观察到A组的平均手术时间有所缩短。所有患者均无需转为开放手术；然而，由于身体状况和粘连，A组有2例患者需要额外置入套管针，手术通过腹腔镜完成。
我们得出结论，SPLC与CLC同样有效。随着外科医生对该技术经验的增加，患者的舒适度提高，疼痛减轻。
