单孔腹腔镜阑尾切除术：超越学习曲线：与多孔腹腔镜阑尾切除术的回顾性比较
Single-port Laparoscopic Appendectomy: Beyond the Learning Curve: A Retrospective Comparison With Multi-port Laparoscopic Appendectomy.
作者信息
Assali Sarah, Eapen Sarah, Carman Terry, Horattas Sophia, Daigle Christopher R, Paranjape Charudutt
机构信息
Department of General Surgery, Cleveland Clinic Akron General Medical Center, Akron, OH.
出版信息
Surg Laparosc Endosc Percutan Tech. 2018 Oct;28(5):291-294. doi: 10.1097/SLE.0000000000000546.
OBJECTIVES
Previous comparisons between single-port laparoscopic appendectomy (SPLA) and multi-port laparoscopic appendectomy have been conflicting and limited. We compare our single-surgeon, SPLA experience with multi-port cases performed during the same time.
METHODS
A retrospective chart review of 128 single-surgeon single-port and 941 multi-port laparoscopic appendectomy cases from April 2009 to December 2014 was conducted.
RESULTS
Patient demographics and preoperative laboratory values were comparable. SPLA was associated with shorter operative time (P=0.0001). There was no statistically significant difference in length of hospitalization, postoperative pain medication use, cost, postoperative complication rates (ileus, urinary retention, deep space infection), or readmission between the 2 groups. There were no postoperative incisional hernias in the single-port group. The single-port group had more postoperative oxycodone use (P=0.0110).
CONCLUSIONS
Our study supports recently published metaanalyses that fail to support older studies demonstrating longer operative times, and higher hernia rates with SPLA.
目的
以往单孔腹腔镜阑尾切除术（SPLA）与多孔腹腔镜阑尾切除术之间的比较结果存在矛盾且有限。我们将单术者的SPLA经验与同期进行的多孔手术病例进行比较。
方法
对2009年4月至2014年12月期间单术者的128例单孔和941例多孔腹腔镜阑尾切除术病例进行回顾性图表分析。
结果
患者人口统计学和术前实验室检查值具有可比性。SPLA与较短的手术时间相关（P = 0.0001）。两组在住院时间、术后止痛药物使用、费用、术后并发症发生率（肠梗阻、尿潴留、深部感染）或再入院方面无统计学显著差异。单孔组无术后切口疝。单孔组术后使用羟考酮更多（P = 0.0110）。
结论
我们的研究支持最近发表的荟萃分析，这些分析不支持早期研究中显示SPLA手术时间更长和疝发生率更高的结果。
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