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论著:经脐单孔腹腔镜胆囊切除术的疗效分析
Evaluation of the Clinical Application of Trans Umbilical Single Port Laparoscopic Cholecystectomy
蒋奕 刘正权 荀祥翰 李荣莉 韩寓嵩 吴国豪
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作者单位:复旦大学附属中山医院普外科
中文关键字:微创外科;经脐;单孔;腹腔镜胆囊切除术
英文关键字:Minimally invasive surgery;Trans umbilicus;Single port;Laparoscopic cholecystectomy
中文摘要:目的:评价经脐单孔腹腔镜胆囊切除术(trans umbilical single port laparoscopic cholecystectomy, TUSPLC)的安全性和适用性。方法:将56例胆囊结石或胆囊息肉患者分为两组,一组患者行经脐单孔腹腔镜胆囊切除术(TUSPLC组,n=24),另一组患者行传统四孔法腹腔镜胆囊切除术(LC组,n=32)。比较两种术式的手术中转率、手术时间、术中出血量、术后住院天数及术后并发症发生率。结果:TUSPLC组平均手术时间长于LC组[(56.08 ± 2.72) min比(18.13±0.73) min,P<0.01]。TUSPLC组和LC组的手术中转率、术中出血量、术后住院天数及术后并发症发生率比较差异均无统计学意义[手术中转率:12.5%比0%,P=0.07;术中出血量:(18.75±1.84)mL比(14.84±1.26) mL,P>0.05;术后住院天数:(3.04±0.16) d比(2.66±0.12) d,P>0.05;术后并发症发生率:4.17%比0%,P=0.43)。TUSPLC组患者术后切口疼痛感较轻,且美容效果优于LC组。结论:TUSPLC的安全性与传统的腹腔镜手术无显著差异,但前者在减少创伤、减轻疼痛和美观方面更具优势。
英文摘要:Objective: To evaluate the safety and applicability of trans umbilical single port laparoscopic cholecystectomy (TUSPLC). Methods: A total of 56 patients with gallbladder stone or polypus were divided into two groups: TUSPLC group (n=24) and laparoscopic cholecystectomy (LC) group (n=32). The conversion rates, operation time, blood loss, length of hospital stay and rates of complications in the two groups were compared. Results: The operation time in TUSPLC group was significantly longer than that in LC group [(56.08±2.72) min vs. (18.13±0.73) min,P<0.01]. There were no significant differences in conversion rates, blood loss, hospital stay and rates of complications between TUSPLC group and LC group (conversion rates: 12.5% vs. 0%,P=0.07;blood loss:(18.75±1.84) mL vs. (14.84±1.26) mL,P>0.05;the length of hospital stay:(3.04±0.16) d vs. (2.66±0.12) d,P>0.05;rates of complications:4.17% vs. 0%,P=0.43). The patients in TUSPLC group had less post operation pain and showed better cosmesis than those patients in LC group. Conclusions: The safety and applicability of TUSPLC are similar to routine LC, but TUSPLC can reduce surface incision and post operation pain and it can also improve cosmesis.
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