Ağcaoğlu Orhan, Aksakal Nihat, Azamat İbrahim Fethi, Doğan Selim, Mercan Selçuk, Barbaros Umut
Department of General Surgery, Koc University Faculty of Medicine, Istanbul, Turkey.
Department of General Surgery, Istanbul University Faculty of Medicine, Istanbul, Turkey.
Sisli Etfal Hastan Tip Bul. 2019 Jun 21;53(2):114-119. doi: 10.14744/SEMB.2019.37880. eCollection 2019.
Single-incision laparoscopic procedures have been gaining popularity in recent years due to their minimal incisional morbidity and improved cosmetic outcomes. Herein, we will compare the feasibility and outcomes of single-incision and conventional multiport laparoscopic distal pancreatectomy.
This study involves consecutive patients who underwent either single-incision or conventional multiport laparoscopic distal pancreatectomy from March 2007 to February 2014. The patients were divided into two groups, based on the surgical approach: single-incision laparoscopic surgery (Group 1) and conventional multiport laparoscopic surgery (Group 2). The parameters evaluated included estimated blood loss, operative time, postoperative pain, duration of hospital stay, complications, conversion, and final pathology.
There were a total of 20 patients, 10 in each study group. Baseline characteristics were similar, and there was no mortality in either of the groups. The low-flow pancreatic fistula was the most commonly seen morbidity, but it was ceased spontaneously in each group by a ratio of 30%. The operative time was significantly shorter in Group 2, with a mean of 116 minutes versus a mean of 180 minutes for Group 1 (p<0.001). One of the procedures in Group 2 was converted to open surgery due to peroperative bleeding. The median follow-up periods of the patients were 22 months and 56 months. The spleen was preserved in only 1 patient from Group 1, whereas in Group 2, the spleen preservation was achieved in 5 patients.
The single-incision laparoscopic technique is a safe and effective alternative to standard laparoscopic distal pancreatectomy.
近年来，单切口腹腔镜手术因其切口发病率极低且美容效果更佳而日益受到欢迎。在此，我们将比较单切口与传统多端口腹腔镜远端胰腺切除术的可行性及手术效果。
本研究纳入了2007年3月至2014年2月期间连续接受单切口或传统多端口腹腔镜远端胰腺切除术的患者。根据手术方式将患者分为两组：单切口腹腔镜手术组（第1组）和传统多端口腹腔镜手术组（第2组）。评估的参数包括估计失血量、手术时间、术后疼痛、住院时间、并发症、中转情况及最终病理结果。
共有20例患者，每组各10例。基线特征相似，两组均无死亡病例。低流量胰瘘是最常见的并发症，但每组均有30%的患者自行痊愈。第2组的手术时间明显更短，平均为116分钟，而第1组平均为180分钟（p<0.001）。第2组有1例手术因术中出血中转开腹。患者的中位随访期分别为22个月和56个月。第1组仅1例患者保留了脾脏，而第2组有5例患者保留了脾脏。
单切口腹腔镜技术是标准腹腔镜远端胰腺切除术的一种安全有效的替代方法。
