腹腔镜胆囊切除术后从上腹部和脐孔取回胆囊的比较评估

Q4 Medicine
Amit Nehra, Surender Verma, Shubham Kochar, Umesh Yadav, Somya Godara, Rajesh Godara
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引用次数: 0

摘要

摘要 腹腔镜胆囊切除术现已成为治疗胆石症的金标准。虽然最近有几篇文章指出,腹腔镜胆囊切除术后从脐孔取出胆囊(GB)的效果更好,但证据并不一致。本研究的目的是比较从上腹部和脐孔取回标本在术后疼痛、所需时间和取回难易程度方面的差异。 共有 200 名 16-80 岁的患者,由第三人从一个装有 200 个密封信封(每组 100 个)的盒子中抽签随机分组。患有急性胆囊炎、气肿、粘液瘤、疑似恶性肿瘤、转为开腹手术和长期使用镇痛剂的患者被排除在外。手术由顾问外科医生在标准全身麻醉下进行,采用四孔技术,并根据抽签结果通过上腹部或脐孔提取胆囊标本。标本取回的难度由手术医生根据主观线性量表进行评分,术后端口部位疼痛由住院医生根据视觉模拟量表进行盲法评估。 两组患者在年龄、性别、体重指数和合并症方面完全匹配。上腹部组的平均取出时间为 36.76 ± 6.26 秒,而脐部组为 22.48 ± 5.76 秒(P < .01)。我们观察到,经脐孔取材比经上腹腔取材容易(评分为 2.72 ± 1.42 vs. 6.48 ± 1.32,P. 001)。上腹部组患者的视觉模拟量表分别为 6.56±0.768、5.60±1.225、4.56±1.325 和 2.72±1.308 vs. 4.16±1.214、2.72±1.275、1.76±1.234 和。脐带组在 1、6、12 和 24 小时时的 P 值分别为 92±0.759 和 92±0.759。不同时间段的 P 值分别为001,因此表明脐带组疼痛较轻。 就取回 GB 所需的时间、取回的难易程度和术后疼痛而言,脐孔优于上腹部孔。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative Evaluation of Gall Bladder Retrieval from Epigastric vs Umbilical Port After Laparoscopic Cholecystectomy
ABSTRACT Laparoscopic cholecystectomy has now become gold standard treatment for gallstone diseases. Although few recent articles suggest that after laparoscopic cholecystectomy gall bladder (GB) retrieval from umbilical port is better, but the evidence is inconsistent. The objective of this study was to compare specimen retrieval from epigastric vs. umbilical port in terms of postoperative pain, time taken, and ease of retrieval. Total 200 patients aged 16-80 years were randomized by drawing lottery slips by a third person from a box containing 200 sealed envelopes (100 for each group). Those with acute cholecystitis, empyema, mucocele, suspected malignancy, and conversion to open and chronic analgesic users were excluded. Surgery was done by consultant surgeon under standard general anesthesia with four-port technique and GB was extracted either through epigastric or umbilical port as per draw. The difficulty in specimen retrieval was graded by operating surgeon on subjective linear scale and postoperative port site pain was assessed by resident blinded to intervention with Visual Analog Scale. Both groups were well matched regarding age, sex, body mass index, and comorbidities. Mean time taken to retrieve in epigastric group was 36.76 ± 6.26 vs. 22.48 ± 5.76 seconds in umbilical group (P < .01). We observed easy retrieval via umbilical port compared to epigastric (score 2.72 ± 1.42 vs. 6.48 ± 1.32, P. 001). Epigastric group patients had Visual Analog Scale 6.56±0.768, 5.60 ± 1.225, 4.56 ± 1.325, and 2.72 ± 1.308 vs. 4.16 ± 1.214, 2.72 ± 1.275, 1.76 ± 1.234, and. 92±0.759 at 1, 6, 12, and 24 hours in umbilical group. The P value at different timings were. 001, thus indicating less pain in umbilical group. Umbilical port is better than epigastric port in terms of time taken for GB retrieval, ease of retrieval, and postoperative pain.
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来源期刊
CiteScore
0.30
自引率
0.00%
发文量
221
审稿时长
43 weeks
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