Chung Han Sol, Jung Sung Min, Lee Mee-Ri, Shin Yong Chan, Jun Heung Man, Kim Jae Il, Choi Pyung Wha
Department of Surgery, University of Inje College of Medicine, Ilsan Paik Hospital, Goyang, Korea.
Department of Preventive Medicine and Institute of Occupational and Environmental Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
J Minim Invasive Surg. 2019 Mar;22(1):11-17. doi: 10.7602/jmis.2019.22.1.11. Epub 2019 Mar 15.
We designed a modified technique to perform an advanced procedure using conventional instruments and did not employ specialized single-incision laparoscopic surgery (SILS) port equipment. We compared postoperative results for transumbilical, single-port laparoscopic appendectomy (TUSPLA) and single-incision, 2-port laparoscopic appendectomy (SITPLA).
This retrospective study enrolled 77 patients who underwent TUSPLA or SITPLA to provide more minimally invasive surgery between May 2017 and April 2018. TUSPLA was performed in 39 patients and 38 underwent SITPLA. In the SITPLA group, two 5-mm trocars were inserted through the umbilicus and an extra puncture site was used for a left-handed instrument. Demographic characteristics, operative data, and postoperative outcomes were collected and compared between the groups.
The mean total operative time in the SITPLA group was shorter than in the TUSPLA group (=0.003). The mean laparoscopic instrumental time was also shorter (<0.001) in the SITPLA. The number of postoperative analgesics in the SITPLA group was less than in the TUSPLA group (=0.002). The length of hospital day after surgery was shorter in the SITPLA group than in the TUSPLA group (=0.008). There were no other significant differences between the groups.
SITPLA had a shorter operative time, required less pain management, and had a similar cosmetic outcome when compared with TUSPLA.
我们设计了一种改良技术，使用传统器械进行一种进阶手术，且未使用专门的单切口腹腔镜手术（SILS）端口设备。我们比较了经脐单孔腹腔镜阑尾切除术（TUSPLA）和单切口双孔腹腔镜阑尾切除术（SITPLA）的术后结果。
这项回顾性研究纳入了2017年5月至2018年4月期间接受TUSPLA或SITPLA以提供更微创手术的77例患者。39例患者接受了TUSPLA，38例接受了SITPLA。在SITPLA组中，通过脐部插入两个5毫米套管针，并使用一个额外的穿刺部位用于左手器械。收集并比较两组的人口统计学特征、手术数据和术后结果。
SITPLA组的平均总手术时间比TUSPLA组短（=0.003）。SITPLA组的平均腹腔镜器械操作时间也更短（<0.001）。SITPLA组术后镇痛药的使用数量比TUSPLA组少（=0.002）。SITPLA组术后住院天数比TUSPLA组短（=0.008）。两组之间没有其他显著差异。
与TUSPLA相比，SITPLA手术时间更短，所需的疼痛管理更少，且美容效果相似。
