Choi Geun Joo, Kang Hyun, Kim Beom Gyu, Choi Yoo Shin, Kim Jin Yun, Lee Sangseok
Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
J Surg Res. 2017 May 15;212:122-129. doi: 10.1016/j.jss.2017.01.023. Epub 2017 Jan 30.
The aim of this study was to compare postoperative pain outcomes between single-incision laparoscopic appendectomy (SILA) and conventional laparoscopic appendectomy (CLA) using a propensity score matching analysis.
Adult patients who underwent SILA or CLA for acute appendicitis between January 2010 and December 2015 at a single center were identified retrospectively from a prospectively collected database. All patients had used an intravenous patient-controlled analgesia (PCA) device for postoperative pain control. As potential confounding variables, patient characteristics and surgery-related, anesthesia-related, and PCA-related factors were collected from the database. The primary outcome was the postoperative pain score, and secondary outcomes were nausea, vomiting, rescue analgesic use, rescue antiemetic use, and PCA-related complications. These outcomes were compared between the SILA and CLA groups before and after 1:1 propensity score matching.
From a total of 915 patients, 753 were selected: 116 in the SILA group and 637 in the CLA group. After propensity score matching, two comparable groups with 111 patients each were obtained. Pain score (P = 0.007) and rescue analgesic use (P = 0.043) on the day of surgery were significantly lower in the SILA group than in the CLA group. The other outcomes were similar between the two groups.
SILA is a beneficial surgical procedure for postoperative pain management.
本研究旨在通过倾向评分匹配分析比较单切口腹腔镜阑尾切除术（SILA）与传统腹腔镜阑尾切除术（CLA）的术后疼痛结果。
回顾性分析2010年1月至2015年12月在单中心接受SILA或CLA治疗急性阑尾炎的成年患者，这些患者来自前瞻性收集的数据库。所有患者术后均使用静脉自控镇痛（PCA）装置控制疼痛。从数据库中收集患者特征、手术相关、麻醉相关和PCA相关因素作为潜在混杂变量。主要结局为术后疼痛评分，次要结局为恶心、呕吐、使用解救镇痛药、使用解救止吐药及PCA相关并发症。在1:1倾向评分匹配前后，比较SILA组和CLA组的这些结局。
共纳入915例患者，其中753例被选中：SILA组116例，CLA组637例。倾向评分匹配后，得到两组各111例可比患者。SILA组手术当天的疼痛评分（P = 0.007）和解救镇痛药使用情况（P = 0.043）均显著低于CLA组。两组的其他结局相似。
SILA是一种有利于术后疼痛管理的手术方式。
