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单孔腹腔镜胆囊切除术对全身氧化应激的影响:一项前瞻性临床试验。

The effect of single incision laparoscopic cholecystectomy on systemic oxidative stress: a prospective clinical trial.

作者信息

Ece Ilhan, Ozturk Bahadir, Yilmaz Huseyin, Yormaz Serdar, Şahin Mustafa

机构信息

Department of Surgery, Faculty of Medicine, Selcuk University, Konya, Turkey.

Department of Biochemistry, Faculty of Medicine, Selcuk University, Konya, Turkey.

出版信息

Ann Surg Treat Res. 2017 Apr;92(4):179-183. doi: 10.4174/astr.2017.92.4.179. Epub 2017 Mar 24.

Abstract

PURPOSE

Single incision laparoscopic cholecystectomy (SILC) has become a more frequently performed method for benign gallbladder diseases all over the world. The effects of SILC technique on oxidative stress have not been well documented. The aim of this study was to evaluate the effect of laparoscopic cholecystectomy techniques on systemic oxidative stress by using ischemia modified albumin (IMA).

METHODS

In total, 70 patients who had been diagnosed with benign gallbladder pathology were enrolled for this prospective study. Twenty-one patients underwent SILC and 49 patients underwent laparoscopic cholecystectomy (LC). All operations were performed under a standard anesthesia protocol. Serum IMA levels were analysed before operation, 45 minutes and 24 hours after operation.

RESULTS

Demographics and preoperative characteristics of the patients were similiar in each group. The mean duration of operation was 37.5 ± 12.5 and 44.6 ± 14.3 minutes in LC and SILC group, respectively. In both groups, there was no statistically significant difference in hospital stay, operative time, or conversion to open surgery. Operative technique did not effect the 45th minute and 24th hour IMA levels. However, prolonged operative time (>30 minutes) caused an early increase in the level of IMA. Twenty-fourth hour IMA levels were not different.

CONCLUSION

SILC is an effective and safe surgical prosedure for benign gallbladder diseases. Independent of the surgical technique for cholecystectomy, the prolonged operative time could increase the tissue ischemia.

摘要

目的

单孔腹腔镜胆囊切除术(SILC)已成为全球范围内治疗良性胆囊疾病更常用的方法。SILC技术对氧化应激的影响尚未得到充分记录。本研究的目的是通过使用缺血修饰白蛋白(IMA)评估腹腔镜胆囊切除术技术对全身氧化应激的影响。

方法

本前瞻性研究共纳入70例被诊断为良性胆囊病变的患者。21例患者接受了SILC,49例患者接受了腹腔镜胆囊切除术(LC)。所有手术均在标准麻醉方案下进行。在手术前、手术后45分钟和24小时分析血清IMA水平。

结果

每组患者的人口统计学和术前特征相似。LC组和SILC组的平均手术时间分别为37.5±12.5分钟和44.6±14.3分钟。两组在住院时间、手术时间或转为开放手术方面均无统计学显著差异。手术技术对第45分钟和第24小时的IMA水平没有影响。然而,手术时间延长(>30分钟)导致IMA水平早期升高。第24小时的IMA水平没有差异。

结论

SILC是治疗良性胆囊疾病的一种有效且安全的手术方法。无论胆囊切除术的手术技术如何,手术时间延长都会增加组织缺血。

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