单孔腹腔镜乙状结肠切除术与多孔腹腔镜乙状结肠切除术治疗憩室炎的比较

SILS sigmoidectomy versus multiport laparoscopic sigmoidectomy for diverticulitis.

作者信息

D'Hondt Mathieu, Pottel Hans, Devriendt Dirk, Van Rooy Frank, Vansteenkiste Franky, Van Ooteghem Barbara, De Corte Wouter

机构信息

Department of Digestive Surgery, Groeninge Hospital, Kortrijk, Belgium.

Interdisciplinary Research Center, Catholic University Leuven, Kortrijk, Belgium.

出版信息

JSLS. 2014 Jul-Sep;18(3). doi: 10.4293/JSLS.2014.00319.

DOI:10.4293/JSLS.2014.00319

PMID:25392639

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4154429/

Abstract

BACKGROUND AND OBJECTIVES

In this single-institution study, we aimed to compare the safety, feasibility, and outcomes of single-incision laparoscopic sigmoidectomy (SILSS) with multiport laparoscopic sigmoidectomy (MLS) for recurrent diverticulitis.

METHODS

Between October 2011 and February 2013, 60 sigmoidectomies were performed by the same surgeon. Forty patients had a MLS and 20 patients had a SILSS. Outcomes were compared.

RESULTS

Patient characteristics were similar. There was no difference in morbidity, mortality or readmission rates. The mean operative time was longer in the SILSS group (P=.0012). In a larger proportion of patients from the SILSS group, 2 linear staplers were needed for transection at the rectum (P=.006). The total cost of disposable items was higher in the SILSS group (P<.0001). No additional ports were placed in the SILSS group. Return to bowel function or return to oral intake was faster in the SILSS group (P=.0446 and P=.0137, respectively). Maximum pain scores on postoperative days 1 and 2 were significantly less for the SILSS group (P=.0014 and P=.047, respectively). Hospital stay was borderline statistically shorter in the SILSS group (P=.0053). SILSS was also associated with better cosmesis (P<.0011).

CONCLUSION

SILSS is feasible and safe and is associated with earlier recovery of bowel function, a significant reduction in postoperative pain, and better cosmesis.

摘要

背景与目的

在这项单机构研究中，我们旨在比较单切口腹腔镜乙状结肠切除术（SILSS）与多端口腹腔镜乙状结肠切除术（MLS）治疗复发性憩室炎的安全性、可行性及手术效果。

方法

2011年10月至2013年2月期间，同一位外科医生实施了60例乙状结肠切除术。其中40例患者接受了MLS，20例患者接受了SILSS。对手术效果进行比较。

结果

患者特征相似。两组在发病率、死亡率或再入院率方面无差异。SILSS组的平均手术时间更长（P = 0.0012）。SILSS组中有更大比例的患者在直肠横断时需要使用2个直线缝合器（P = 0.006）。SILSS组一次性物品的总成本更高（P < 0.0001）。SILSS组未额外放置端口。SILSS组患者肠功能恢复或恢复经口进食更快（分别为P = 0.0446和P = 0.0137）。SILSS组术后第1天和第2天的最大疼痛评分显著更低（分别为P = 0.0014和P = 0.047）。SILSS组的住院时间在统计学上略短（P = 0.0053）。SILSS的美容效果也更好（P < 0.0011）。