Comparative study of single-port single-channel and single-port multi-channel adrenalectomy in various maximum tumor diameters.

IF 1.6 3区 医学 Q2 SURGERY
Pengcheng Zhang, Yuhan Pei, Yunlai Zhi, Fanghu Sun, Ninghong Song
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引用次数: 0

Abstract

Background: Investigating the application of single-port single-channel and single-port multi-channel adrenalectomy in various maximum tumor diameters.

Methods: Retrospective analysis of clinical data from 218 adrenal tumors treated with single-port retroperitoneoscopic adrenalectomy at Lianyungang Clinical Medical College of Nanjing Medical University from September 2018 to November 2023. All adrenal tumors are benign lesions classified as T1 stage. Tumors were classified into three groups based on their maximum diameter: ≤3 cm (Group A), >3 cm and ≤ 4 cm (Group B), and > 4 cm and ≤ 5 cm (Group C). Based on the surgical approach, patients were divided into single-port single-channel and single-port multi-channel groups. Group A had an average tumor diameter of (2.32 ± 0.45) cm with 46 single-port single-channel and 53 single-port multi-channel cases; Group B had (3.42 ± 0.31) cm with 33 single-port single-channel and 45 single-port multi-channel cases; Group C had (4.60 ± 0.28) cm with 18 single-port single-channel and 23 single-port multi-channel cases. Comparisons were made between single-port single-channel and single-port multi-channel groups in terms of operation time, hospital stay, intraoperative bleeding, postoperative pain score, surgical complications, incision length (total length of all incisions), and the need for additional puncture holes for each tumor size group.

Results: All 218 surgeries were successfully completed without conversion to open surgery. In Group A, no significant difference was observed between single-channel and multi-channel groups in terms of operation time and blood loss (P > 0.05), but significant differences were found in hospital stay, pain score, subcutaneous emphysema incidence, and incision length (P < 0.05). In Group B, there was no significant difference between single-channel and multi-channel groups regarding operation time and blood loss (P > 0.05), but significant differences were observed in hospital stay, pain score, subcutaneous emphysema incidence, and incision length (P < 0.05). In Group C, no significant difference was observed between single-channel and multi-channel groups in terms of hospital stay, blood loss, pain score, incision length, vascular injury, and subcutaneous emphysema incidence (P > 0.05), but significant differences were found in operation time and the incidence of additional puncture holes (P < 0.05). Postoperative follow-up ranged from 4 to 22 months, with an average of 11.5 months, and no complications were observed.

Conclusions: Single-port single-channel laparoscopy has significant advantages in surgeries for tumors with a maximum diameter ≤ 4 cm, as it can directly reach the target organ, reduce separation operations, cause less damage, and has good cosmetic effects. For adrenal tumor surgeries with a maximum diameter > 4 cm, the multi-channel technique is superior to the single-channel technique in terms of shorter hospital stay and the need for additional punctures.

单孔单通道与单孔多通道肾上腺切除术对不同最大肿瘤直径的比较研究。
背景:探讨单孔单通道和单孔多通道肾上腺切除术在不同最大肿瘤直径下的应用。方法:回顾性分析2018年9月至2023年11月南京医科大学连云港临床医学院单孔后腹腔镜肾上腺切除术218例肾上腺肿瘤的临床资料。肾上腺肿瘤均为良性病变,分期为T1期。根据肿瘤最大直径分为≤3cm组(A组)、>≥3cm≤4cm组(B组)、>≥4cm≤5cm组(C组)。根据手术入路将患者分为单孔单通道组和单孔多通道组。A组平均肿瘤直径为(2.32±0.45)cm,单孔单通道46例,单孔多通道53例;B组为(3.42±0.31)cm,单口单通道33例,单口多通道45例;C组为(4.60±0.28)cm,单通道18例,多通道23例。比较单孔单通道组与单孔多通道组的手术时间、住院时间、术中出血、术后疼痛评分、手术并发症、切口长度(所有切口的总长度)、各肿瘤大小组额外穿刺孔的需要。结果:218例手术均顺利完成,无中转开腹。A组单通道组与多通道组手术时间、出血量差异无统计学意义(P < 0.05),住院时间、疼痛评分、皮下肺气肿发生率、切口长度差异有统计学意义(P < 0.05),住院时间、疼痛评分、皮下肺气肿发生率、切口长度差异有统计学意义(P < 0.05);结论:单孔单通道腹腔镜在最大直径≤4 cm的肿瘤手术中具有明显优势,可直接到达靶器官,减少分离手术,损伤小,美容效果好。对于最大直径4cm的肾上腺肿瘤手术,多通道技术在缩短住院时间和需要额外穿刺方面优于单通道技术。
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来源期刊
BMC Surgery
BMC Surgery SURGERY-
CiteScore
2.90
自引率
5.30%
发文量
391
审稿时长
58 days
期刊介绍: BMC Surgery is an open access, peer-reviewed journal that considers articles on surgical research, training, and practice.
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