Department of Surgery, Konyang University Hospital, Konyang University College of Medicine, 158, Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Korea.
Surg Endosc. 2023 May;37(5):3548-3556. doi: 10.1007/s00464-022-09846-y. Epub 2023 Jan 5.
To compare the short-term outcomes of robotic single-site cholecystectomy (RSSC) with single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC), focusing on postoperative pain outcomes.
This single-center retrospective study included consecutive patients with benign gallbladder disease who underwent cholecystectomy by a single surgeon between June 2019 and December 2021. Exclusion criteria were acute cholecystitis (AC) and other combined surgeries. One-to-one propensity score matching was performed between the RSSC and SILC or CMLC.
Of the 157 patients included, 39 (24.8%) underwent RSSC, 32 (20.4%) underwent SILC, and 86 (54.8%) underwent CMLC. In a propensity score-matched cohort between RSSC and SILC (32 patients in each group), the number of additional analgesic injections was significantly lower in the RSSC group than in the SILC group (0.7 vs. 1.3, p = 0.002), and postoperative pain scores were also significantly lower at 6 h (2.8 vs. 3.6, p = 0.004) and 24 h (2.6 vs. 3.3, p = 0.021) after surgery in the RSSC group than in the SILC group. In a propensity score-matched cohort between RSSC and CMLC (23 patients in each group), the number of additional analgesic injections was significantly lower in the RSSC group than in the CMLC group (0.7 vs. 1.3, p = 0.005), and postoperative pain scores were also significantly lower at 6 h after surgery (2.9 vs. 3.7, p = 0.025) in the RSSC group than in the CMLC group.
This study demonstrated that RSSC is helpful in reducing postoperative pain and the use of additional analgesics compared to both SILC and CMLC.
本研究旨在比较单部位机器人胆囊切除术(RSSC)与单孔腹腔镜胆囊切除术(SILC)和传统多孔腹腔镜胆囊切除术(CMLC)的短期疗效,重点关注术后疼痛结局。
这是一项单中心回顾性研究,纳入了 2019 年 6 月至 2021 年 12 月期间由同一位外科医生行胆囊切除术的良性胆囊疾病患者。排除标准为急性胆囊炎(AC)和其他联合手术。RSSC 组与 SILC 组或 CMLC 组进行一对一倾向评分匹配。
本研究共纳入 157 例患者,其中 39 例行 RSSC(24.8%),32 例行 SILC(20.4%),86 例行 CMLC(54.8%)。在 RSSC 与 SILC 的倾向评分匹配队列(每组 32 例)中,RSSC 组的附加镇痛注射次数明显少于 SILC 组(0.7 比 1.3,p=0.002),RSSC 组术后 6 小时(2.8 比 3.6,p=0.004)和 24 小时(2.6 比 3.3,p=0.021)的术后疼痛评分也明显低于 SILC 组。在 RSSC 与 CMLC 的倾向评分匹配队列(每组 23 例)中,RSSC 组的附加镇痛注射次数明显少于 CMLC 组(0.7 比 1.3,p=0.005),RSSC 组术后 6 小时的术后疼痛评分也明显低于 CMLC 组(2.9 比 3.7,p=0.025)。
与 SILC 和 CMLC 相比,RSSC 有助于减轻术后疼痛和减少额外镇痛药物的使用。