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单孔与传统多孔腹腔镜下淋巴结活检术比较。

Single-Port vs. Conventional Multi-Port Laparoscopic Lymph Node Biopsy.

机构信息

Surgical Clinic Unit I, Department of Surgical Sciences and Integrated Diagnostics, Genoa University, Genoa, Italy.

Hematology and Transplant Center Division, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

出版信息

JSLS. 2020 Oct-Dec;24(4). doi: 10.4293/JSLS.2020.00045.

Abstract

BACKGROUND AND OBJECTIVES

The purpose of the investigation was to compare clinical results and diagnostic accuracy for conventional multiport laparoscopic lymph node biopsy (MPLB) and single-port laparoscopic lymph node biopsy (SPLB) operations at a single institution.

METHODS

A set of 20 SPLB patients operated on from October 2016 to May 2019 were compared to an historical series of 35 MPLB patients. Primary endpoints were the time of surgery, estimated blood loss, surgical conversion, length of stay and morbidity. The secondary endpoint was the diagnostic accuracy of the technique.

RESULTS

SPLB was completed laparoscopically in all cases. Two MPLB patients (5.7%) experienced a surgical conversion due to intraoperative difficulties. Duration of surgery was similar in SPLB and MPLB groups respectively (84 ± 31.7 min vs. 81.1 ± 22.2; = .455). A shorter duration of hospital stay was shown for patients operated on by SPLB compared to the MPLB group (1.7 ± 0.9 days vs. 2.1 ± 1.2 days; =.133). The postoperative course was uneventful in both groups. In 95% of the SPLB and 97.1% of the MPLB cases respectively, LLB achieved the necessary information for the diagnosis.

CONCLUSION

SPLB has shown good procedural and postoperative outcomes as well as a high diagnostic yield, comparable to traditional MPLB. Therefore, our results show that this approach is safe and effective and can be an equally valid option to MPLB to obtain a diagnosis or to follow the progression of a lymphoproliferative disease. Further studies are necessary to support these results before its widespread adoption.

摘要

背景与目的

本研究旨在比较单孔腹腔镜下淋巴结活检术(SPLB)与传统多孔腹腔镜下淋巴结活检术(MPLB)在单中心的临床效果和诊断准确性。

方法

对 2016 年 10 月至 2019 年 5 月期间行 SPLB 的 20 例患者与一组历史对照的 35 例行 MPLB 的患者进行比较。主要研究终点为手术时间、估计失血量、手术中转、住院时间和并发症。次要研究终点为该技术的诊断准确性。

结果

所有 SPLB 患者均成功完成腹腔镜手术。2 例 MPLB 患者(5.7%)因术中困难而中转开腹。SPLB 和 MPLB 组的手术时间分别为 84±31.7 分钟和 81.1±22.2 分钟( =.455),无显著差异。SPLB 组的住院时间明显短于 MPLB 组(1.7±0.9 天 vs. 2.1±1.2 天; =.133)。两组患者术后均恢复顺利。SPLB 组 95%和 MPLB 组 97.1%的患者均获得了诊断所需的信息。

结论

SPLB 具有良好的手术和术后效果以及较高的诊断率,与传统 MPLB 相当。因此,我们的研究结果表明,该方法安全有效,可作为 MPLB 的有效替代方法,用于获得诊断或监测淋巴增殖性疾病的进展。在广泛应用之前,还需要进一步的研究来支持这些结果。

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