2种隐瘢痕腹腔镜胆囊切除术的比较研究

目的探讨三孔法隐瘢痕腹腔镜胆囊切除术（1aparoscopic cholecystectomy，LC）的有效性和安全性。方法2008年8月。2010年4月70例良性胆囊疾患随机接受2种隐瘢痕Lc，其中三孔法35例，单孔法35例。比较2种隐瘢痕Lc的手术时间、术中出血量、术后住院时间、住院费用、术后疼痛和美容效果。结果三孔组术中出血量（21．3±11．8）ml与单孔组（24．3±11．2）ml相比无显著差异（t=1．091，P=0．270）；三孔组术后住院时间（1．5±0．6）d与单孑L组（1．5±0．7）d相比无显著差异（t=0．000，P：1．000）；三孔组住院费用（8639．6±617．4）元与单孔组（8631．2±8lO．7）元相比无显著差异（t=-0．049，P=0．961）；三孔组术后第2天VAS评分为（1．1±0．4）分与单孔组（1．2±0．4）分相比无显著差异（t=-1．046，P=0．299）；三孔组美容满意度评分（1．1±0．4）分与单孔组（1．1±0．3）分相比无显著差异（污0．000，P=1．000）。三孔组手术时间（15．1±5．9）min比单孔组（45．5±11．0）min明显缩短（t=14．408，P=0．000）；三孔组术后第1天VAs评分（2．9±1．4分）比单孔组（4．6±2．0）分显著降低（t=-3．985，P=0．000）。65例（三孔组33例，单孔组32例）随访6-24个月，平均13个月．均无并发症。结论三孔法隐瘢痕腹LC是一种安全和有效的术式。

Comparative Study of Two Approaches for Scar-hidden Laparoscopic Cholecystectomy

Objective To explore the safety and feasibility of three trocar scar hidden laparoscopic cholecystectomy （ I,C）. Methods From August 2008 to April 2010, totally 70 patients with benign gallbladder diseases received scar hidden LC via two different approaches： 35 of the eases received three trocar approach and the other 35 cases underwent single trocar approach. The operation time, blood loss, postoperative hospital stay and cost, and postoperative pain were compared between the two groups. Results There were no statistically significant difference between the three and single trocar groups in blood loss [ （21.3 ± 11.8） ml vs. （24.3±11.2） ml, t = 1. 091, P = 0. 270], postoperative hospital stay [ （ 1.5 ± 0.6） days vs. （ 1.5 ~ 0.7 ） days, t = 0. 000, P = 1.000], hospital cost [（8639.6±617.4） RMB vs. （8631.2 ±810.7） RMB, t= -0.049, P=0.961]. second day VAS [1.1± 0.4 vs. 1.2 ±0.4, t= -1.046, P=0.299], and cosmetic scores [1.1±0.4 vs. 1.1 ±0.3, t=O. 000, P=I.O001. However, the three trocar group showed significantly shorter operation time and lower first day VAS [ （ 15. l ± 5.9） rain vs. （ 45.5± l 1. O） rain, t = 14.408, P=0.000; 2.9±1.4 vs. 4.6 ±2.0, t= -3.985, P=0.000].A mean of 13 months （6 -24 months） follow up was achieved in 65 patients （33 cases from the three trocar group and 32 cases from single trocar group） , during which no complication occurred. Conclusions Three trocar scar hidden LC is safe and effective.