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单孔机器人胆囊切除术与传统三孔腹腔镜胆囊切除术的临床效果比较。

Clinical outcomes of single-incision robotic cholecystectomy versus conventional 3-port laparoscopic cholecystectomy.

机构信息

From the Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

出版信息

Can J Surg. 2019 Feb 1;62(1):52-56. doi: 10.1503/cjs.000118.

Abstract

BACKGROUND

Few studies have compared the surgical results of single-incision robotic cholecystectomy (SIRC) with those of conventional laparoscopic cholecystectomy (CLC). The purpose of this study was to evaluate the relative clinical efficacy of SIRC by comparing the number of postoperative days, pain level and complications between the 2 surgical methods.

METHODS

We retrospectively collected demographic, perioperative and postoperative data for all patients who underwent SIRC or CLC performed by a single surgeon from June 2016 to May 2017. Operative time was recorded, divided into anesthesia time, docking time, console time and total operation time. Postoperative pain was measured with the Numerical Pain Rating Scale.

RESULTS

A total of 121 patients underwent cholecystectomy during the study period, of whom 61 had SIRC and 60 had CLC. The mean total operation time of SIRC and CLC was 93.52 (SD 20.27) minutes and 37.67 (SD 19.73) minutes, respectively (p < 0.001). The total operation time excluding console time of SIRC was significantly longer than that of CLC (82.77 [SD 18.27] min v. 37.67 [SD 19.73] min) (p < 0.001). The mean Numerical Pain Rating Scale score was 4.73 (SD 1.23) (SIRC: 4.75 [SD 1.24]; CLC: 4.70 [SD 1.22]) (p = 0.8) within 1 hour after the operation; scores after 6 hours and 1 day decreased in a similar manner in the 2 groups (p = 0.1).

CONCLUSION

Postoperative pain, use of an additional port, complication rates, operation time and cost of SIRC were similar to or greater than those of CLC. Large randomized controlled trials are needed to examine the true benefits of SIRC.

摘要

背景

鲜有研究比较单孔机器人胆囊切除术(SIRC)与传统腹腔镜胆囊切除术(CLC)的手术结果。本研究旨在通过比较两种手术方法的术后天数、疼痛程度和并发症,评估 SIRC 的相对临床疗效。

方法

我们回顾性收集了 2016 年 6 月至 2017 年 5 月期间由同一位外科医生行 SIRC 或 CLC 的所有患者的人口统计学、围手术期和术后数据。记录手术时间,分为麻醉时间、对接时间、控制台时间和总手术时间。术后疼痛采用数字疼痛评分量表测量。

结果

研究期间共 121 例患者行胆囊切除术,其中 61 例行 SIRC,60 例行 CLC。SIRC 和 CLC 的平均总手术时间分别为 93.52(SD 20.27)分钟和 37.67(SD 19.73)分钟(p<0.001)。SIRC 不包括控制台时间的总手术时间明显长于 CLC(82.77(SD 18.27)min v. 37.67(SD 19.73)min)(p<0.001)。术后 1 小时内,数字疼痛评分量表评分分别为 4.73(SD 1.23)(SIRC:4.75(SD 1.24);CLC:4.70(SD 1.22))(p=0.8),两组术后 6 小时和 1 天的评分均呈相似下降趋势(p=0.1)。

结论

SIRC 的术后疼痛、使用附加端口、并发症发生率、手术时间和费用与 CLC 相似或更高。需要进行大型随机对照试验来检验 SIRC 的真正获益。

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本文引用的文献

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Robotic single-site cholecystectomy.机器人单孔胆囊切除术
J Hepatobiliary Pancreat Sci. 2014 Jan;21(1):18-25. doi: 10.1002/jhbp.36. Epub 2013 Oct 21.

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