经脐单孔与三孔腹腔镜胆囊切除术的对比研究

目的：评价经脐单孔腹腔镜胆囊切除术的安全性、可行性及优缺点。方法：收集2009年4月至2012年5月400例经脐单孔腹腔镜胆囊切除术,随机抽取100例作为A组;收集同一时段的三孔法腹腔镜胆囊切除术1 150例,随机抽取100例作为B组。采用回顾性病例对照研究方法,将两组患者相关指标进行对比研究,使用标准统计软件SPSS 17.0对数据进行处理。结果：A组患者术中出血量、术后疼痛程度、术后满意度明显优于B组（P〈0.05）,术中胆囊破损例数、手术时间、术后进食时间、术后并发症发生率、术后住院时间及住院费用两组差异无统计学意义（P〉0.05）。结论：经脐单孔腹腔镜胆囊切除术的安全性、可行性与三孔法腹腔镜胆囊切除术相当,其手术入路更加微创,并具有腹部美容的效果,患者术后疼痛程度轻,对手术满意度高,具有一定优势,值得临床推广开展。

Comparative study of transumbilical single-port and three-port laparoscopic cholecystectomy

Objective：To evaluate the safety,feasibility,advantages and disadvantages of the transumbilical single-port laparo- scopic cholecystectomy. Methods ： The clinical data of 400 cases of transumbilical single-port laparoscopic choleeystectomy from Apr. 2009 to May 2012 were collected, 100 cases were randomly selected from them as group A. 1 150 cases of three-port laparoscopic chole- cysteetomy in the same period were collected, lO0 cases from them were randomly selected as group B ,then a retrospective case-control study was made on the related data of the 2 groups. The standard statistical software SPSS 17.0 was used to analyze the data. Results： The baseline data of the two groups were comparable （ P 〉 O. 05 ）. The blood loss, the postoperative pain and the postoperative satisfac- tion of group A was significantly better than group B （ P 〈 0.05 ）. There were no significant differences in the number of the patient whose gallbladder was damaged, the operation time, the postoperative feeding time, the incidence of postoperative complications, the postoperative hospital stay and hospitalization cost （ P 〉 0.05 ）. Conclusions ： Compared to the three-port laparoscopic cholecystectomy, the transumbilical single-port laparoscopic eboleeystectomy is not significantly different in the safety and feasibility. The surgical ap- proach is more minimally invasive, this procedure has better cosmetic effect, milder postoperative pain, and higher satisfaction rate, so it is worthy to tie spreaded and developed in clinic.