迷你腹腔镜胆囊切除术是否比金标准更好?一项比较研究。

Is mini-laparoscopic cholecystectomy any better than the gold standard?: A comparative study.

作者信息

Shaikh Haris R, Abbas Asad, Aleem Salik, Lakhani Miqdad R

机构信息

Department of Surgery, Ziauddin University Hospital, Nazimabad, Karachi, Pakistan.

出版信息

J Minim Access Surg. 2017 Jan-Mar;13(1):42-46. doi: 10.4103/0972-9941.181368.

Abstract

BACKGROUND

Mini-laparoscopic cholecystectomy (MLC) has widened the horizons of modern laparoscopic surgery. Standard four port laparoscopic cholecystectomy (SLC), which has long been established as the "Gold Standard" for gall bladder diseases, is under reconsideration following the advent of further minimally-invasive procedures including MLC. Our study aims to provide a comparison between MLC and SLC and assesses whether MLC has any added benefits.

MATERIALS AND METHODS

Patients with symptomatic gall bladder disease undergoing MLC or SLC during the 2.5-month period were included in the study. Thirty-two patients underwent MLC while SLC was performed on 40 patients by the same surgeon. Data was collected prospectively and analysed retrospectively using a predesigned questionnaire.

RESULTS

In our study, both the groups had similar age, body mass index (BMI) and gender distribution. No cases of MLC required insertion of additional ports. The mean operative time for MLC was 38.2 min (33-61 min), which is longer than SLC; but it was not statistically significant. There was no significant difference in mean operative blood loss, postoperative pain, analgesia requirement and mobilization. Patients who underwent MLC were able to return to normal activity earlier than patients undergoing SLC (P < 0.01).

CONCLUSION

Our experience suggests that MLC can safely be used as an alternative to SLC. Compared to SLC, it has the added benefit of an early return to work along with excellent cosmetic results. Further large scale trials are required to prove any additional benefit of MLC.

摘要

背景

迷你腹腔镜胆囊切除术(MLC)拓宽了现代腹腔镜手术的视野。长期以来一直被确立为胆囊疾病“金标准”的标准四孔腹腔镜胆囊切除术(SLC),在包括MLC在内的进一步微创手术出现后正受到重新审视。我们的研究旨在比较MLC和SLC,并评估MLC是否有任何额外的益处。

材料与方法

纳入在2.5个月期间接受MLC或SLC的有症状胆囊疾病患者。32例患者接受了MLC,40例患者由同一位外科医生进行了SLC。前瞻性收集数据,并使用预先设计的问卷进行回顾性分析。

结果

在我们的研究中,两组患者的年龄、体重指数(BMI)和性别分布相似。没有MLC病例需要插入额外的端口。MLC的平均手术时间为38.2分钟(33 - 61分钟),比SLC长,但无统计学意义。平均术中失血量、术后疼痛、镇痛需求和活动能力方面无显著差异。接受MLC的患者比接受SLC的患者更早恢复正常活动(P < 0.01)。

结论

我们的经验表明,MLC可安全地用作SLC的替代方法。与SLC相比,它具有早日恢复工作以及出色美容效果的额外益处。需要进一步的大规模试验来证明MLC的任何额外益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e79/5206838/bbbaa0f92d6e/JMAS-13-42-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索