Rajapandian Subbiah, Bhushan Chittawadagi, Sabnis Sandeep C, Jain Manish, Raj Palanivelu Praveen, Parathasarthi Ramakrishnan, Senthilnathan Palanisamy, Palanivelu Chinnusamy
Department of Surgical Gastroenterology and Laparoscopic Surgery, GEM Hospital and Research Centre, Coimbatore, Tamil Nadu, India.
J Minim Access Surg. 2018 Jan-Mar;14(1):44-51. doi: 10.4103/jmas.JMAS_30_17.
The popularity of single-incision procedures is on the rise as wound cosmesis is increasingly being seen as an important body image-related outcome. In this study, we assess the potential benefits of single-incision multiport laparoscopic totally extra-peritoneal (S-TEP) without using specialised ports or instruments and compare the same with the conventional laparoscopic TEP (C-TEP) surgery in terms of operative time, post-operative pain, complications, cost and cosmesis.
This is a prospective case-matched study of the patients undergoing S-TEP versus C-TEP from June 2014 to December 2015.
Each group had 36 patients. The two groups were comparable in the clinical characteristics. The mean duration of surgery for a unilateral hernia in C-TEP and S-TEP was 45.13 ± 10.58 min and 72.63 ± 15.23 min, respectively. The mean visual analogue scale (VAS) score for pain was significantly higher in S-TEP group at post-operative day (POD) 0 and 1. However, at POD 7, there was no significant difference between the groups. At 1st and 6-week post-surgery, the cosmetic results were significantly better in S-TEP group as compared to C-TEP, however, at 6 months, the scar was highly acceptable in both treatment groups.
S-TEP, using conventional laparoscopic instruments, is safe and feasible even in resource challenged setting. However, there is a need to review the indications and advantages of single-incision laparoscopic surgery, as no difference in cosmetic outcome by VAS score in S-TEP versus conventional laparoscopic arm seen by the end of 1 month.
随着伤口美观日益被视为与身体形象相关的重要结果，单切口手术越来越受欢迎。在本研究中，我们评估了不使用专门端口或器械的单切口多端口腹腔镜完全腹膜外手术（S-TEP）的潜在益处，并在手术时间、术后疼痛、并发症、成本和美观方面将其与传统腹腔镜TEP（C-TEP）手术进行比较。
这是一项对2014年6月至2015年12月接受S-TEP与C-TEP手术患者的前瞻性病例对照研究。
每组有36例患者。两组在临床特征方面具有可比性。C-TEP和S-TEP治疗单侧疝的平均手术时间分别为45.13±10.58分钟和72.63±15.23分钟。术后第0天和第1天，S-TEP组的平均视觉模拟评分（VAS）疼痛评分显著更高。然而，在术后第7天，两组之间没有显著差异。术后第1周和第6周，S-TEP组的美容效果明显优于C-TEP组，然而，在6个月时，两个治疗组的疤痕都非常容易接受。
即使在资源有限的情况下，使用传统腹腔镜器械的S-TEP也是安全可行的。然而，有必要重新审视单切口腹腔镜手术的适应症和优势，因为在1个月末，S-TEP组与传统腹腔镜组在VAS评分的美容结果上没有差异。
