经脐单切口与传统腹腔镜胆囊切除术的短期疗效对比:回顾性队列研究。

IF 1.1 4区 医学 Q3 SURGERY
Fuguo Liu, Ran Cui, Muladili Mutailipu, Zinan Zhao, Xujing Wang, Bo Chen, Yongkun Wang
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引用次数: 0

摘要

背景:随着人们对微创手术和美观手术的需求不断增加,经脐单切口腹腔镜胆囊切除术(SILC)已被越来越多的医疗中心采用,尽管数量有限。我们的团队已成功实施了经脐单孔腹腔镜胆囊切除术(SILC)治疗良性胆囊疾病。本研究回顾性分析并比较了经脐 SILC 与传统腹腔镜胆囊切除术(CLC)的疗效。方法:我们分析了同济大学附属上海东方医院在 2021 年 1 月至 2023 年 10 月期间实施的 358 例腹腔镜胆囊切除术的数据。其中,186 例接受了 SILC(观察组),172 例接受了 CLC(对照组)。我们比较了患者的人口统计学特征、围手术期结果以及对切口疤痕的满意度。主要结果包括手术疗效和安全性,次要结果包括术后住院时间、疼痛程度、住院费用和疤痕满意度。结果:两组患者的人口统计学特征无明显差异。SILC 组和 CLC 组的手术时间(39.56 ± 14.55 分钟对 41.82 ± 16.13 分钟,P = .164)和术中失血量(11.34 ± 3.90 mL 对 11.28 ± 3.87 mL,P = .885)相似。单切口方法使术后肠道功能恢复更早(22.03 ± 3.60 小时对 24.17 ± 3.22 小时,P < .01),术后 24 小时疼痛评分更低(2.06 ± 0.84 对 2.35 ± 0.72,P < .01),术后住院时间更短(2.88±0.86天对3.33±0.96天,P < .01),住院费用相当(3411.67±790.86美元对3494.50±558.76美元,P = .257),疤痕美观评估和评级评分更好(1.78±0.70对2.17±0.89,P < .01)。单切口技术的患者满意度更高(8.52 ± 0.79 对 7.80 ± 0.75,P < .01)。两组均有一例切口感染(SILC 0.54%,CLC 0.58%),CLC 组有一例术后胆汁渗漏(0.58%)。然而,并发症的差异无统计学意义(P > .05)。结论经脐 SILC 具有安全、有效的近期疗效,可减轻术后疼痛并改善外观效果,支持临床采用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Short-Term Efficacy of Transumbilical Single-Incision Versus Conventional Laparoscopic Cholecystectomy: A Retrospective Cohort Study.

Background: With the rising demand for minimally invasive and cosmetically appealing surgeries, transumbilical single-incision laparoscopic cholecystectomy (SILC) has been increasingly adopted, albeit in a limited number of medical centers. Our team has successfully executed transumbilical SILC for benign gallbladder diseases. This study retrospectively analyzed and compared the efficacy of transumbilical SILC with that of conventional laparoscopic cholecystectomy (CLC). Methods: We analyzed data from 358 cases of laparoscopic cholecystectomy performed at Shanghai East Hospital of Tongji University between January 2021 and October 2023. Of these, 186 cases underwent SILC (observation group), while 172 cases underwent CLC (control group). We compared patient demographics, perioperative outcomes, and satisfaction with incision scars. Primary outcomes included surgical efficacy and safety, whereas secondary outcomes encompassed postoperative hospitalization duration, pain levels, hospital costs, and scar satisfaction. Results: No significant differences were observed in patient demographics between the two groups. Both the SILC and CLC groups exhibited similar operative times (39.56 ± 14.55 minutes versus 41.82 ± 16.13 minutes, P = .164) and intraoperative blood loss (11.34 ± 3.90 mL versus 11.28 ± 3.87 mL, P = .885). The single-incision approach led to earlier postoperative bowel function recovery (22.03 ± 3.60 hours versus 24.17 ± 3.22 hours, P < .01), lower 24-hour postoperative pain scores (2.06 ± 0.84 versus 2.35 ± 0.72, P < .01), shorter postoperative hospital stays (2.88 ± 0.86 days versus 3.33 ± 0.96 days, P < .01), comparable hospitalization costs (3411.67 ± 790.86$ versus 3494.50 ± 558.76$, P = .257), and better Scar Cosmesis Assessment and Rating scores (1.78 ± 0.70 versus 2.17 ± 0.89, P < .01). Patient satisfaction was higher with the single-incision technique (8.52 ± 0.79 versus 7.80 ± 0.75, P < .01). Both groups experienced one case of incision infection (SILC 0.54%, CLC 0.58%), and there was one case of postoperative bile leakage in the CLC group (0.58%). However, the difference in complications was not statistically significant (P > .05). Conclusion: Transumbilical SILC demonstrates safe and effective near-term efficacy, offering benefits such as reduced postoperative pain and improved cosmetic outcomes, which support its clinical adoption.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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