Tang Yingming, Li Fei, He Guoqing
Department of Pediatric surgery, Guizhou Province People's Hospital, Guiyang, Guizhou People's Republic of China.
Indian J Surg. 2016 Aug;78(4):259-264. doi: 10.1007/s12262-015-1348-y. Epub 2015 Sep 12.
The purpose of this study was to elucidate the potential benefits of single-incision laparoscopic Roux-en-Y hepaticojejunostomy comparing the conventional laparoscopic procedures. From January 2013 to July 2013, 17 consecutive children with choledochal cysts received single-incision laparoscopic Roux-en-Y hepaticojejunostomies by a single surgeon at our institution. Seventeen standard laparoscopic hepaticojejunostomies of consecutive children with choledochal cysts from July 2012 to December 2012 were employed as control. Demographic and perioperative information was identified retrospectively using clinic and hospital records including gender, age, total operating time, estimated blood loss, time to oral intake, drainage removal time, postoperative complications, and postoperative hospital stay. One patient was converted to open surgery and another 8-year-old boy conversed to conventional four-port laparoscopic procedure. There were no significant differences between the conventional laparoscopic group and the single-incision laparoscopic group with regard to preoperative variables including age (P = 0.697) and sex distribution (P = 1.000). For mean operative time (209.9 ± 7.5 vs 204.1 ± 6.9 min, P = 0.951), estimated blood loss (10.7 ± 1.1 vs 13.4 ± 1.7 ml, P = 0.103), time to oral intake (3.73 ± 0.21 vs 3.77 ± 0.20 days, P = 0.889), drainage removal time (4.20 ± 0.45 vs 4.06 ± 0.23 days, P = 0.067), and postoperative hospital stay (7.60 ± 0.25 vs 7.41 ± 0.21 days, P = 0.627), the differences were also nonsignificant. Nevertheless, this technique demonstrated improved cosmetic outcomes comparing with the conventional laparoscopic group. The results showed better cosmetic results and comparable postoperative outcomes. However, well-designed prospective studies are warranted to better address this issue.
本研究的目的是通过比较传统腹腔镜手术，阐明单切口腹腔镜Roux-en-Y肝空肠吻合术的潜在益处。2013年1月至2013年7月，在我们机构，同一位外科医生为17例连续性胆总管囊肿患儿实施了单切口腹腔镜Roux-en-Y肝空肠吻合术。选取2012年7月至2012年12月连续性胆总管囊肿患儿的17例标准腹腔镜肝空肠吻合术作为对照。通过临床和医院记录回顾性确定人口统计学和围手术期信息，包括性别、年龄、总手术时间、估计失血量、开始经口进食时间、引流管拔除时间、术后并发症及术后住院时间。1例患者转为开放手术，另1例8岁男孩转为传统四孔腹腔镜手术。传统腹腔镜组和单切口腹腔镜组在术前变量（包括年龄，P = 0.697；性别分布，P = 1.000）方面无显著差异。对于平均手术时间（209.9 ± 7.5 vs 204.1 ± 6.9分钟，P = 0.951）、估计失血量（10.7 ± 1.1 vs 13.4 ± 1.7毫升，P = 0.103）、开始经口进食时间（3.73 ± 0.21 vs 3.77 ± 0.20天，P = 0.889）、引流管拔除时间（4.20 ± 0.45 vs 4.06 ± 0.23天，P = 0.067）及术后住院时间（7.60 ± 0.25 vs 7.41 ± 0.21天，P = 0.627），差异也无统计学意义。然而，与传统腹腔镜组相比，该技术显示出更好的美容效果。结果表明美容效果更好且术后结果相当。然而，需要设计良好的前瞻性研究来更好地解决这一问题。
