Lakdawala Muffazal, Agarwal Aditi, Dhar Shilpa, Dhulla Neha, Remedios Carlyne, Bhasker Aparna Govil
Center for Obesity and Digestive Surgery, Mumbai, India.
Obes Surg. 2015 Apr;25(4):607-14. doi: 10.1007/s11695-014-1461-1.
This is a 2-year study to evaluate the feasibility; outcomes in terms of postoperative pain, weight loss, and complication rates; and cosmesis of the single-incision sleeve gastrectomy versus the conventional multiport sleeve gastrectomy.
A prospective comparative analysis was done in 300 patients in each arm who underwent laparoscopic sleeve gastrectomy and single-incision sleeve gastrectomy from September 2009 till January 2012. Both groups were matched for age and BMI. Postoperative pain scoring was done using visual analogue scale. Outcomes in terms of pain score, scar satisfaction score, excess weight loss, resolution of co-morbidities, and complications were compared in both groups at the end of 6 months, 1 year, and 2 years.
Female patients preferred to undergo single-incision sleeve gastrectomy. Operating time and intraoperative blood loss were comparable in both groups. Visual analogue scale (VAS) scoring revealed lesser postoperative pain in the single-incision group. Excess weight loss and resolution of co-morbidities were also comparable in both groups at 6 months, 1 year, and 2 years. Incisional hernia was seen in 3 patients (1%) in the single-incision group. Leak rate was comparable. Cosmetic satisfaction was superior in patients who underwent single-incision surgery.
Surgical outcomes are comparable in both groups at the end of 2 years. The myth of high long-term incisional hernia rate after single-incision surgery has been dispelled. Single-incision surgery is less painful with better cosmesis. It has come of age and should no longer be considered as an experimental procedure.
这是一项为期两年的研究，旨在评估单切口袖状胃切除术与传统多端口袖状胃切除术的可行性；术后疼痛、体重减轻和并发症发生率方面的结果；以及美容效果。
对2009年9月至2012年1月期间接受腹腔镜袖状胃切除术和单切口袖状胃切除术的每组300例患者进行前瞻性比较分析。两组在年龄和体重指数方面进行了匹配。术后疼痛评分采用视觉模拟量表。在6个月、1年和2年结束时，比较两组在疼痛评分、疤痕满意度评分、超重减轻、合并症缓解和并发症方面的结果。
女性患者更倾向于接受单切口袖状胃切除术。两组的手术时间和术中出血量相当。视觉模拟量表（VAS）评分显示单切口组术后疼痛较轻。在6个月、1年和2年时，两组的超重减轻和合并症缓解情况也相当。单切口组有3例患者（1%）出现切口疝。渗漏率相当。接受单切口手术的患者美容满意度更高。
两组在两年结束时的手术结果相当。单切口手术后长期切口疝发生率高的传言已被消除。单切口手术疼痛较轻，美容效果更好。它已经成熟，不应再被视为一种实验性手术。
