García-Valdecasas J C, Almenara R, Cabrer C, de Lacy A M, Sust M, Taurá P, Fuster J, Grande L, Pera M, Sentis J
Department of Surgery, Medical School, Hospital Clinic, University of Barcelona, Spain.
Br J Surg. 1988 May;75(5):473-5. doi: 10.1002/bjs.1800750523.
We report the results of a prospective and randomized trial designed to study the incidence of abdominal and pulmonary complications in gallstone surgery comparing subcostal (SI) with midline incision. The need for postoperative analgesia was lower in the SI group. There was no difference in the degree of hypoxaemia in the first two postoperative days, but there was less impairment of pulmonary function in terms of vital capacity and forced expiratory volume in 1 s (P less than 0.0001) in the SI group. SI patients also had a lower incidence of pulmonary or abdominal complications but the difference was not significant. Finally, we found a reduced hospital stay for the SI patients (P less than 0.01), probably related to a reduced postoperative analgesic requirement and an improved pulmonary function. We conclude that subcostal incision is a better approach for biliary tract surgery and should be used whenever possible.
我们报告了一项前瞻性随机试验的结果，该试验旨在研究胆囊结石手术中肋下切口（SI）与正中切口相比腹部和肺部并发症的发生率。SI组术后镇痛需求较低。术后前两天低氧血症程度无差异，但SI组在肺活量和第1秒用力呼气量方面肺功能损害较小（P小于0.0001）。SI组患者肺部或腹部并发症的发生率也较低，但差异不显著。最后，我们发现SI组患者住院时间缩短（P小于0.01），这可能与术后镇痛需求减少和肺功能改善有关。我们得出结论，肋下切口是胆道手术的更好方法，应尽可能采用。
