Jang Eun Jeong, Roh Young Hoon, Choi Chan Joong, Kim Min Chan, Kim Kwan Woo, Choi Hong Jo
Dong-A University College of Medicine, Busan, South Korea.
Department of Surgery, Dong-A University College of Medicine, Busan, South Korea.
JSLS. 2014 Jul-Sep;18(3). doi: 10.4293/JSLS.2014.00048.
Single-port laparoscopic cholecystectomy may contribute to a paradigm shift in the field of laparoscopic cholecystectomy surgery by providing patients with benefits beyond those observed after other surgical procedures. This study was designed to evaluate clinically meaningful differences in operative outcomes between obese and nonobese patients after single-port laparoscopic cholecystectomy.
Data were collected retrospectively from 172 patients who had undergone single-port laparoscopic cholecystectomy performed by the same surgeon at a single medical center between January and December 2011. For the outcome analysis, patients were divided into nonobese and obese patient groups according to their body mass index (<25 kg/m2 vs ≥25 kg/m2).
Demographic and clinical data did not differ significantly between obese patients (n=65) and nonobese patients (n=107). In addition, statistically significant differences pertaining to most measured surgical outcomes including postoperative hospital stay, bile spillage, additional port use, and open conversion were not detected between the groups. However, the two groups differed significantly regarding operative time such that nonobese patients had shorter operative times than obese patients (P<.05).
The results of this study showed that operative time for single-port laparoscopic cholecystectomy was the only difference between obese and nonobese patients. Given this result, body mass index may not be as relevant a factor in patient selection for single-port laparoscopic cholecystectomy as previously thought.
单孔腹腔镜胆囊切除术可为患者带来超越其他手术的益处,这可能促使腹腔镜胆囊切除术领域发生范式转变。本研究旨在评估肥胖与非肥胖患者接受单孔腹腔镜胆囊切除术后手术结局的临床显著差异。
回顾性收集了2011年1月至12月期间在单一医疗中心由同一位外科医生实施单孔腹腔镜胆囊切除术的172例患者的数据。为进行结局分析,根据体重指数将患者分为非肥胖组和肥胖组(<25kg/m²对比≥25kg/m²)。
肥胖患者(n = 65)与非肥胖患者(n = 107)的人口统计学和临床数据无显著差异。此外,两组之间在包括术后住院时间、胆汁渗漏、额外端口使用和中转开腹等大多数测量的手术结局方面未检测到统计学显著差异。然而,两组在手术时间上存在显著差异,非肥胖患者的手术时间比肥胖患者短(P <.05)。
本研究结果表明,单孔腹腔镜胆囊切除术的手术时间是肥胖与非肥胖患者之间的唯一差异。鉴于此结果,体重指数在单孔腹腔镜胆囊切除术患者选择中可能不像先前认为的那样是一个相关因素。