经脐单孔腹腔镜与传统腹腔镜治疗胆囊良性疾病的对比研究 |
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引用本文: | 林叶,金浩生,简志祥. 经脐单孔腹腔镜与传统腹腔镜治疗胆囊良性疾病的对比研究[J]. 南方医科大学学报, 2013, 33(8): 1199 |
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作者姓名: | 林叶 金浩生 简志祥 |
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摘 要: | 目的探讨经脐单孔腹腔镜胆囊切除的安全性与有效性。方法回顾性分析本院2011年4月~2012年10月开展单孔腹腔 镜胆囊切除,简志祥主任单人完成的141例单孔腹腔镜胆囊切除病例患者,并与同期进行的传统腹腔镜胆囊切除的患者进行对 比分析。结果在141例单孔腹腔镜胆囊切除病例中,3例因胆囊三角显露不清改行多孔腹腔镜胆囊切除术,2例中转开腹行传 统胆囊切除,术后发生1例不明原因的肠穿孔,发现脐部脂肪液化2例,与同期传统腹腔镜胆囊切除的306例患者对比分析发现, 两组患者年龄、性别、BMI及腹部手术史等未见统计学差异(P>0.05),两组患者手术时间(28.5±19.3 min vs 33.4±14.2 min,P= 0.001)、术中出血量(6.4±18.9 ml vs 9.8±20.6 ml,P=0.06)、关腹所需时间(5.1±3.8 min vs 5.8±4.3 min,P=0.06)及术后并发症(3/ 141 vs 5/306,P=1.00)未见明显统计学差异,但TSPLC组中转开腹率(2/141 vs 25/306,P=0.001)及术后住院天数(1.2±1.4 d vs 2.6±1.7 d,P<0.01)均相对于传统腹腔镜少,术后患者满意程度两组比较亦有显著统计学差异(8.5±1.1 分vs 7.9±0.7 分,P< 0.01)。结论经脐单孔腹腔镜胆囊切除术安全有效,且术后患者满意程度普遍较高,值得有条件的医院采用。
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Research on the safety and effectiveness of transumbilical single port laparoscopic cholecystectomy |
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Abstract: | Objective To evaluate the safety and effectiveness of transumbilical single port laparoscopic cholecystectomy (TSPLC). Methods A retrospective analysis was conducted for the 141 patients, who received TSPLC by DR. Jian in our hospital since April 2011 to October 2012, and the operative and postoperative effects of these patients were evaluated by comparing with that of the conventional laparoscopic cholecystectomy (CLC). Results In the total of 141 TSPLC cases that included in the study, 3 cases converted to CLC. 2 cases converted to open cholecystectomy. Additionally, 1 case was diagnosed as an unexplained bowel perforation after operation, fat liquefaction occurred in 2 patients. When comparing with these cases to 306 CLC patients, there was no obvious statistical difference in the terms of patients’ age, gender, BMI and abdominal surgery history (P>0.05). Meanwhile, There were similar effects of the two groups of patients on the operation time (28.5±19.3 min vs 33.4±14.2 min,P=0.001), estimate blood loss (6.4±18.9 ml vs 9.8±20.6 ml,P=0.06), the time needed for closing abdomen (5.1±3.8 min vs 5.8±4.3 min,P=0.06) and postoperative complications (3/141 vs 5/306,P=1.00). However, the TSPLC group was superior to CLC group in the terms of the conversion rate (2/141 vs 25/306,P=0.001), and postoperative hospitalization (1.2±1.4 d vs 2.6±1.7 d,P<0.01), meanwhile, TSPLC was also superior to LC on the satisfactory degree of operative effect through the one week‘s follow-up (8.5±1.1 vs 7.9±0.7,P<0.01). Conclusion TSPLC is both safer and more effective than that of CLC, and thus it is worth adopting in selected hospitals.
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