Paolucci V, Schaeff B, Gutt C N, Encke A
Department of General Surgery, Johann-Wolfgang-Goethe University, Frankfurt am Main, Germany.
Endosc Surg Allied Technol. 1995 Apr-Jun;3(2-3):147-50.
We quantified and compared the advantages and disadvantages of disposable and reusable laparoscopic instruments in a prospective, randomised study of 158 cholecystectomies. The patients were randomly divided into two groups: 80 underwent surgery with reusable instruments, 78 with disposable instruments. The following parameters were recorded in both groups: duration of surgery, number of complications, technical problems during surgery, rate of conversion to open surgery, subjective postoperative pain, postoperative hospitalisation time, length of inability to work, and postoperative evaluation by the operating room personnel. No overall differences were found in subjective pain, postoperative complications, postoperative hospitalisation time, or time before returning to work. Surgery with disposable instruments was on the whole faster, with fewer conversions to open surgery, but this was statistically non-significant. Reusable instruments were associated with a statistically significant increase in the rate of intraoperative, instrument-related difficulties. In spite of longer operation times and higher personnel costs with reusable instruments, we found that cholecystectomy with reusable instruments costs an average of 1,015 DM less per procedure.
在一项针对158例胆囊切除术的前瞻性随机研究中，我们对一次性和可重复使用的腹腔镜器械的优缺点进行了量化和比较。患者被随机分为两组：80例使用可重复使用器械进行手术，78例使用一次性器械。两组均记录了以下参数：手术时间、并发症数量、手术中的技术问题、转为开放手术的比例、术后主观疼痛、术后住院时间、无法工作的时长以及手术室人员的术后评估。在主观疼痛、术后并发症、术后住院时间或恢复工作前的时间方面，未发现总体差异。使用一次性器械进行手术总体上更快，转为开放手术的情况更少，但这在统计学上无显著意义。可重复使用器械与术中器械相关困难发生率的统计学显著增加有关。尽管使用可重复使用器械的手术时间更长且人员成本更高，但我们发现，使用可重复使用器械进行胆囊切除术，每例手术平均成本低1015德国马克。
