Hyun In Gun, Choi YoungRok, Han Ho-Seong, Yoon Yoo-Seok, Cho Jai Young, Kim Kil Hwan, Han Sunjong
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
J Gastrointest Surg. 2021 Mar;25(3):681-687. doi: 10.1007/s11605-020-04527-4. Epub 2020 Mar 10.
We introduced solo surgery using a laparoscopic scope holder to wide an operator's activity range and reduce instrument crowding and clashing in single incisional surgery. This study aimed to compare the surgical outcomes of solo single-incision laparoscopic surgery (SILS) and conventional multiport laparoscopic surgery (MULS) for hepatocellular carcinoma (HCC).
Among 477 consecutive patients between January 2004 and December 2017, 214 patients were included. To overcome selection bias, we performed 1:1 match using propensity score matching between SILS and MULS. Baseline characteristics, operative outcomes, and postoperative complications were compared.
No significant differences in baseline characteristics and pathologic features were found between the two groups. Operation time, estimated blood loss, and postoperative major complication were not significantly different (119.0 min vs 141.6 min, p = 0.275; 200.0 mL min vs 373.3 min, p = 0.222; 0 vs 0, p = 1.000). However, postoperative hospital stay was significantly shorter in SILS (2.73 days vs 7.67 days, p = 0.005).
Solo SILS had comparable postoperative complications and feasibility in the aspect of operation time and hospital stay compared with conventional MULS for a favorable located single HCC.
我们引入了使用腹腔镜持镜器的单人手术，以扩大术者的活动范围，并减少单切口手术中器械的拥挤和碰撞。本研究旨在比较单人单切口腹腔镜手术（SILS）与传统多端口腹腔镜手术（MULS）治疗肝细胞癌（HCC）的手术效果。
在2004年1月至2017年12月期间连续收治的477例患者中，纳入了214例患者。为克服选择偏倚，我们采用倾向评分匹配法在SILS组和MULS组之间进行1:1匹配。比较两组的基线特征、手术结果和术后并发症。
两组在基线特征和病理特征方面未发现显著差异。手术时间、估计失血量和术后主要并发症无显著差异（119.0分钟对141.6分钟，p = 0.275；200.0毫升对373.3毫升，p = 0.222；0对0，p = 1.000）。然而，SILS组的术后住院时间明显更短（2.73天对7.67天，p = 0.005）。
对于位置良好的单个HCC，与传统MULS相比，单人SILS在术后并发症以及手术时间和住院时间方面具有相当的可行性。
