Department of Surgery, Chungnam National University College of Medicine, Daejeon, Korea; Department of Surgery, Chungnam National University Hospital, Daejeon, Korea.
Department of Surgery, Chungnam National University College of Medicine, Daejeon, Korea; Department of Surgery, Chungnam National University Hospital, Daejeon, Korea.
Surgery. 2023 Oct;174(4):774-780. doi: 10.1016/j.surg.2023.06.003. Epub 2023 Jul 28.
Classic laparoscopic cholecystectomy) using multiple ports is a widely used method with excellent surgical outcomes. However, the resulting wounds do not meet the cosmetic needs of patients. Therefore, this study aimed to find a new minimally invasive surgical method for invisible wounds while maintaining surgical safety through a new port site.
In this prospective cohort study, we used propensity score matching analysis to evaluate the perioperative outcomes of multiport laparoscopic cholecystectomy using articulating devices with the lower abdominal approach. We performed a propensity score matching analysis of prospectively maintained data from 228 patients who underwent classic laparoscopic cholecystectomy using straight instruments and laparoscopic cholecystectomy with a lower abdominal approach using articulating devices between January and October 2022. A single surgeon performed all operations included in the study. We evaluated several perioperative outcomes.
No differences were found in potential confounding factors, such as sex, age, admission type, previous abdominal surgery, and medical comorbidities, between the 2 groups after propensity score matching. In the classic laparoscopic cholecystectomy group, the mean operation time was shorter (43.73 ± 23.71 vs 50.60 ± 9.75 min; P < .04). No significant difference was noted in the 2 groups' numerical rating scale scores for pain, body mass index, and incidence of postoperative complications. The mean length of hospital stay was longer for patients who underwent classic laparoscopic cholecystectomy (4.27 vs 2.07 days; P = .064). The lower abdominal laparoscopic cholecystectomy group had delayed defecation after surgery.
Regarding surgical outcomes and minimal invasiveness, lower abdominal laparoscopic cholecystectomy is a feasible cholecystectomy method.
经典腹腔镜胆囊切除术（使用多个端口）是一种广泛应用的方法，具有出色的手术效果。然而，由此产生的伤口不符合患者的美容需求。因此，本研究旨在寻找一种新的微创方法，通过新的端口部位实现隐形伤口，同时保持手术安全性。
在这项前瞻性队列研究中，我们使用倾向评分匹配分析来评估使用下腹部入路的铰接装置进行多孔腹腔镜胆囊切除术的围手术期结果。我们对 2022 年 1 月至 10 月期间使用直器械进行经典腹腔镜胆囊切除术和使用铰接装置进行下腹部入路腹腔镜胆囊切除术的 228 例患者的前瞻性维护数据进行了倾向评分匹配分析。所有纳入研究的手术均由一名外科医生完成。我们评估了几种围手术期结果。
在倾向评分匹配后，两组在潜在混杂因素（如性别、年龄、入院类型、既往腹部手术和合并症）方面没有差异。在经典腹腔镜胆囊切除术组中，手术时间更短（43.73 ± 23.71 分钟比 50.60 ± 9.75 分钟；P <.04）。两组患者的疼痛数字评分量表评分、体重指数和术后并发症发生率无显著差异。接受经典腹腔镜胆囊切除术的患者的平均住院时间更长（4.27 天比 2.07 天；P =.064）。下腹部腹腔镜胆囊切除术组术后排便延迟。
就手术结果和微创性而言，下腹部腹腔镜胆囊切除术是一种可行的胆囊切除术方法。
