Angulo Javier C, Pérez Sergio, García-Tello Ana, Redondo Cristina, Meilán Elisa, Arance Ignacio
Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Laureate International Universities, Madrid, Spain.
Urol Int. 2016;97(2):179-85. doi: 10.1159/000444419. Epub 2016 Mar 2.
We compared perioperative results and complications of reconstructive surgery of the urinary tract performed using a multichannel platform through the umbilicus and one additional 3.5-mm with a cohort of patients simultaneously treated with conventional 4-port laparoscopy.
Matched-pair study comparing perioperative outcomes, postoperative visual analogue pain scale (VAPS) and morbidity of 2-port (n = 20) and 4-port (n = 10) laparoscopic reconstructive urological surgery. Preoperative and perioperative data compared included demographics, type of surgery, operative time, blood loss, decrease in serum hemoglobin, operative complications, length of stay and postoperative complications according to Clavien-Dindo classification.
There was no significant difference between groups regarding age, gender, body mass index, American Society of Anesthesiologists score, type of surgery, operative time, operative complications and intraoperative or postoperative transfusion. Estimated blood loss was lower using reduced-port approach. VAPS at postoperative day one was significantly lower for 2-port approach and so was the length of stay. Patient satisfaction with the wound was higher for 2-port surgery. Differences were not observed in number and severity of postoperative complications.
Urological reconstructive operations can be safely performed using the hybrid laparoendoscopic single-site umbilical approach, resulting in lower blood loss, higher patient satisfaction and lower postoperative pain, which also facilitate earlier hospital discharge, than the same reconstructive procedures performed through multiport conventional laparoscopy.
我们将通过脐部多通道平台及另外一个3.5毫米切口进行的尿路重建手术的围手术期结果和并发症，与同期接受传统四孔腹腔镜手术的一组患者进行了比较。
配对研究，比较两孔（n = 20）和四孔（n = 10）腹腔镜泌尿外科重建手术的围手术期结果、术后视觉模拟疼痛量表（VAPS）和发病率。比较的术前和围手术期数据包括人口统计学、手术类型、手术时间、失血量、血清血红蛋白下降情况、手术并发症、住院时间以及根据Clavien-Dindo分类的术后并发症。
两组在年龄、性别、体重指数、美国麻醉医师协会评分、手术类型、手术时间、手术并发症以及术中或术后输血方面无显著差异。采用减少切口入路时估计失血量更低。两孔入路术后第一天的VAPS显著更低，住院时间也是如此。两孔手术患者对伤口的满意度更高。术后并发症的数量和严重程度未见差异。
与通过多端口传统腹腔镜进行的相同重建手术相比，采用混合腹腔镜单部位脐部入路可安全地进行泌尿外科重建手术，导致失血量更低、患者满意度更高、术后疼痛更低，这也有助于更早出院。
