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单孔机器人胆囊切除术与单孔腹腔镜胆囊切除术的疗效比较。

Comparison of outcomes of single incision robotic cholecystectomy and single incision laparoscopic cholecystectomy.

作者信息

Lee Sun Min, Lim Jin Hong

机构信息

Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Ann Hepatobiliary Pancreat Surg. 2021 Feb 28;25(1):78-83. doi: 10.14701/ahbps.2021.25.1.78.

Abstract

BACKGROUNDS/AIMS: Multiport laparoscopic cholecystectomy is the standard surgical procedure for symptomatic gallbladder diseases. However, as a result of the ongoing trend toward minimally invasive laparoscopy, single-incision laparoscopic cholecystectomy (SILC) has evolved. Single-incision robotic cholecystectomy (SIRC) can overcome several limitations of manual SILC. The purpose of this study is to evaluate and compare the safety and feasibility of SIRC and SILC.

METHODS

This study retrospectively reviewed data for all patients who underwent SIRC or SILC from March 2018 to July 2019 in a single institution. The following variables were analyzed: age, sex, body mass index, pain scale, length of stay, and complications. The data were analyzed using the Independent two sample t-test or the Fisher's exact test.

RESULTS

A total of 343 patients underwent SIRC or SILC during the study period. After excluding patients with acute cholecystitis, 197 SIRC and 103 SILC patients were analyzed in this study. The surgery time and postoperative hospital stay did not differ between SIRC and SILC. However, the SIRC patients experienced less bile spillage during the surgery than did the SILC patients (SIRC vs. SILC: 24 (23.3%) vs. 11 (5.6%) cases, respectively; <0.001). Although there was no difference in the incidence of postoperative complications between procedures, additional pain control was administered more frequently in SILC patients (SILC 1.08±0.893, SIRC 0.58±0.795; <0.001).

CONCLUSIONS

While both SILC and SIRC are effective for single-incision cholecystectomy, SIRC was superior to SILC in terms of technical stability. Moreover, it has the advantage of postoperative pain control.

摘要

背景/目的:多端口腹腔镜胆囊切除术是治疗有症状胆囊疾病的标准外科手术。然而,由于微创腹腔镜手术的持续发展趋势,单切口腹腔镜胆囊切除术(SILC)应运而生。单切口机器人胆囊切除术(SIRC)可以克服手动SILC的一些局限性。本研究的目的是评估和比较SIRC与SILC的安全性和可行性。

方法

本研究回顾性分析了2018年3月至2019年7月在单一机构接受SIRC或SILC的所有患者的数据。分析了以下变量:年龄、性别、体重指数、疼痛评分、住院时间和并发症。数据采用独立两样本t检验或Fisher精确检验进行分析。

结果

在研究期间,共有343例患者接受了SIRC或SILC。排除急性胆囊炎患者后,本研究分析了197例SIRC患者和103例SILC患者。SIRC和SILC的手术时间和术后住院时间无差异。然而,SIRC患者在手术期间的胆汁渗漏比SILC患者少(SIRC与SILC:分别为24例(23.3%)和11例(5.6%);<0.001)。尽管两种手术术后并发症的发生率没有差异,但SILC患者更频繁地需要额外的疼痛控制(SILC 1.08±0.893,SIRC 0.58±0.795;<0.001)。

结论

虽然SILC和SIRC在单切口胆囊切除术中均有效,但SIRC在技术稳定性方面优于SILC。此外,它在术后疼痛控制方面具有优势。

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