Department of Surgery, Kuopio University Hospital (KUH) and University of Eastern Finland (UEF), Kuopio, Finland
School of Medicine, Kuopio University Hospital (KUH) and University of Eastern Finland (UEF), Kuopio, Finland.
In Vivo. 2022 Nov-Dec;36(6):2835-2839. doi: 10.21873/invivo.13022.
BACKGROUND/AIM: Three-dimensional laparoscopy (3D-Lap) is a recent innovation in surgery. The 3D-Lap is rarely used in cholecystectomy (3D-LC) and there are no prospective studies assessing advantages and disadvantages of 3D-LC versus minilaparotomy (MC) in cholecystectomy.
This was a prospective clinical study conducted in the Kuopio University Hospital, including 200 patients with symptomatic cholelithiasis who were randomized into 3D-LC (n=112) or MC (n=88) groups. The numeric rating scale (NRS) pain score and number of analgesic doses (NAD) following surgery were documented.
Similar low postoperative pain scores were reported in the 3D-LC and MC groups during the first hours following surgery, although the 3D-LC patients reported lower NRS pain score (p<0.05) one hour postoperatively. Interestingly, the 3D-LC patients showed significantly less pain 24 hours following surgery, the mean of NRS of 0-10 score at rest being 1.2 in the 3D-LC group versus 2.2 in the MC group (p<0.001), and the pain at the quick movement/coughing, the mean NRS being 2.9 in the 3D-LC group versus 3.6 in the MC group (p=0.05).
The 3D-LC patients reported significantly lower pain scores 24 hours postoperatively than MC patients. However, the patient experience of pain depends on many factors and our results suggest that both 3D-LC and MC are safe and efficient techniques for cholecystectomy.
背景/目的：三维腹腔镜（3D-Lap）是手术领域的一项新创新。3D-Lap 在胆囊切除术中很少使用，也没有前瞻性研究评估 3D-LC 与小切口（MC）在胆囊切除术中的优缺点。
这是在库奥皮奥大学医院进行的一项前瞻性临床研究，包括 200 例有症状的胆石症患者，他们随机分为 3D-LC（n=112）或 MC（n=88）组。记录手术后的数字评分量表（NRS）疼痛评分和止痛药剂量（NAD）数量。
尽管 3D-LC 患者术后一小时的 NRS 疼痛评分较低（p<0.05），但在手术后的头几个小时，3D-LC 和 MC 组报告的术后疼痛评分相似。有趣的是，3D-LC 患者在手术后 24 小时时疼痛明显减轻，3D-LC 组的 NRS 评分在休息时为 0-10 的平均值为 1.2，而 MC 组为 2.2（p<0.001），在快速移动/咳嗽时的疼痛，NRS 的平均值为 2.9 在 3D-LC 组，而在 MC 组为 3.6（p=0.05）。
3D-LC 患者术后 24 小时的疼痛评分明显低于 MC 患者。然而，患者的疼痛体验取决于许多因素，我们的结果表明，3D-LC 和 MC 都是安全有效的胆囊切除术技术。
