Zhang Lu, Huo Haizhong, Li Hongjie, Luo Meng, Wang Feng, Zhou Yixiong, Li Qingfeng, Zhang Yuguang
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of general surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Plast Reconstr Surg Glob Open. 2022 Mar 7;10(3):e4161. doi: 10.1097/GOX.0000000000004161. eCollection 2022 Mar.
The study aimed to introduce a rib and costal cartilage harvesting surgery by transumbilical single-incision laparoscopy and evaluate its efficiency and safety.
Patients who underwent rib and costal cartilage harvest under different approaches (direct open approach and transumbilical) were collected in this retrospective study. The differences in the pain scores [visual analog scale (VAS)], postoperative appearance, and complications were compared between the two groups at 1, 2, 3, and 7 days after surgery. In addition, based on the minimal clinically important difference and the generalized estimating equation, the differences were compared between the two groups in terms of the VAS score.
On postoperative day 1, the VAS scores of the direct open approach group and the transumbilical group were significantly different, that is, 7.29 and 6.10, respectively ( < 0.001). Also, the generalized estimating equation results were different ( < 0.001). An interaction was observed between different groups and days, that is, a statistical difference was observed in the VAS score between the two groups ( < 0.001). In terms of aesthetics and complications, patients from the transumbilical group had no scars on the chest wall and no obvious postoperative complications.
Transumbilical single-incision laparoscopic surgery is an innovative surgical approach for harvesting ribs and costal cartilage, which leaves no scars on the skin of the chest wall and has the advantages of slight postoperative pain, quick recovery, and fewer complications. This novel surgery is beneficial to patients with higher aesthetic requirements.
本研究旨在介绍一种经脐单切口腹腔镜肋骨及肋软骨采集手术，并评估其有效性和安全性。
本回顾性研究收集了采用不同方法（直接开放法和经脐法）进行肋骨及肋软骨采集的患者。比较两组患者术后1、2、3和7天的疼痛评分[视觉模拟量表（VAS）]、术后外观及并发症情况。此外，基于最小临床重要差异和广义估计方程，比较两组患者VAS评分的差异。
术后第1天，直接开放法组和经脐组的VAS评分有显著差异，分别为7.29和6.10（<0.001）。广义估计方程结果也不同（<0.001）。观察到不同组和天数之间存在交互作用，即两组VAS评分存在统计学差异（<0.001）。在美学和并发症方面，经脐组患者胸壁无瘢痕，术后无明显并发症。
经脐单切口腹腔镜手术是一种用于采集肋骨及肋软骨的创新手术方法，胸壁皮肤无瘢痕，具有术后疼痛轻、恢复快、并发症少等优点。这种新型手术对美学要求较高的患者有益。
