经脐单孔与三孔法腹腔镜胆囊切除术疗效对比

【摘要】目的：探讨经脐单孔腹腔镜胆囊切除术 ( transumbilical single port laparoscopic cholecystectomy， TUSPLC) 的手术可行性和经验体会。方法：回顾性分析我院2020 年3月～2021年11月开展TUSPLC 51例患者及三孔法LC 51例患者的临床资料。结果：TUSPLC组手术时间显著长于三孔法LC组(49.4±13.3)min Vs (31.2±11.51)min]，TUSPLC组增加戳孔的例数显著多于三孔法LC组(5（9.8%)]Vs 1(1.96%))]，差异均有统计学意义（P<0.05）；但TUSPLC组较三孔法LC组，术后止痛剂使用例数更少4（7.85%）Vs17(33.3%)]，术后腹壁疤痕满意度评分更高(3.88±0.11)分 Vs (2.75±0.31)分]，差异均有统计学意义（P<0.05）；TUSPLC组的手术出血量、术后并发症及住院天数与三孔法LC组比较没有差异（P>0.05）。 结论：TUSPLC在有丰富的二孔LC经验的基础上是安全可行的，也是现阶段最能体现NOTES理念的手术，选择合适的患者可做推广。

Comparison of single port and three-port laparoscopic cholecystectomy

Objective To explore the feasibility and effectiveness of transumbilical single port laparoscopic cholecystectomy (TUSPLC) by comparison of single port and three-port laparoscopic cholecystectomy. Methods The clinical data of 51 patients underwent TUSPLC and 51 patients underwent three-port laparoscopic cholecystectomy (LC) in Sijing Hospital from March 2020 to November 2021 were analyzed retrospectively. Results The operation time in the TUSPLC group was significantly longer than that in the three-port LC group (49.4±13.3] min vs31.2±11.5] min, P=0.01), and the rate of patients increasing puncturing port in the TUSPLC group was significantly higher than that in the three-port LC group (9.80% vs 1.96%, P=0.02). Compared with the three-port LC group, postoperative analgesics were used less frequently in the TUSPLC group (7.8% vs 33.3%, P=0.01), and the postoperative abdominal scar satisfaction score was higher (3.88±0.11 vs 2.75±0.31, P=0.01). There was no significant difference in operative blood loss, postoperative complications and hospital stay between the two groups. Conclusion Compared with the traditional three-port LC, TUSPLC has the advantage of less trauma and higher patient satisfaction, and more embodies the concept of natural orifice transluminal endoscopic surgery (NOTES) at the present stage.