Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Asian J Endosc Surg. 2022 Jul;15(3):608-612. doi: 10.1111/ases.13063. Epub 2022 Apr 15.
In laparoscopic liver resection, few reports have investigated the influence of type of incision on postoperative pain in laparoscopic liver resection. We therefore conducted the present study to clarify the difference in postoperative pain between two types of incision.
Nineteen patients who underwent laparoscopic lateral sectionectomy were enrolled. In 11 patients with a transumbilical incision and eight with a suprapubic incision, the operation duration, blood loss, length of incision, duration of intravenous fentanyl infusion immediately after surgery and rescue dosage, and period of regular oral nonsteroidal anti-inflammatory drugs were evaluated.
There was no significant difference between the two groups in patients' background characteristics, operation time, or amount of blood loss. The length of suprapubic incision was significantly longer than the umbilical incision. Concerning the postoperative pain management, the duration of intravenous fentanyl administration was 1 day (1-2 days) for umbilical incisions and 1.5 days (1-2 days) for suprapubic incisions, showing no significant difference. Regarding the rescue dosage of fentanyl, the results were comparable between the groups. Regarding the postoperative duration of regular nonsteroidal anti-inflammatory drug administration, there was also no significant difference between the groups (transumbilical: 14 [5-35] days vs suprapubic: 8 [7-32]).
Postoperative pain is comparable between umbilical and suprapubic incision in patients who underwent laparoscopic left lateral segmentectomy. In terms of postoperative pain, either a transumbilical incision or a suprapubic incision can be selected for specimen extraction.
在腹腔镜肝切除术中,鲜有研究报道切口类型对腹腔镜肝切除术后疼痛的影响。因此,本研究旨在阐明两种切口术后疼痛的差异。
纳入 19 例行腹腔镜左外叶切除术的患者。其中 11 例行经脐切口,8 例行耻骨上切口,评估手术时间、出血量、切口长度、术后即刻静脉注射芬太尼持续时间和补救剂量以及常规口服非甾体抗炎药的持续时间。
两组患者的背景特征、手术时间或出血量无显著差异。耻骨上切口的长度明显长于脐部切口。关于术后疼痛管理,脐部切口的静脉注射芬太尼持续时间为 1 天(1-2 天),耻骨上切口为 1.5 天(1-2 天),无显著差异。关于芬太尼的补救剂量,两组结果相当。关于常规非甾体抗炎药的术后持续使用时间,两组之间也无显著差异(经脐:14 [5-35] 天 vs 耻骨上:8 [7-32] 天)。
腹腔镜左外叶切除术患者中,脐部和耻骨上切口的术后疼痛相当。就术后疼痛而言,经脐切口或耻骨上切口均可用于标本取出。