经脐单孔腹腔镜与传统腹腔镜胆囊切除术的对比研究

Comparative study on transumbilical single port laparoscopic cholecystectomy and conventional laparoscopic cholecystectomy

目的比较经脐单孔腹腔镜胆囊切除术(TUSPLC)与传统腹腔镜胆囊切除术(LC)的手术疗效,探讨经脐单孔腹腔镜胆囊切除术的安全性、可行性及特点。方法选择山西医科大学第一临床医学院普外科近期施行的经脐单孔腹腔镜胆囊切除术50例为单孔组,同一医师施行的传统腹腔镜胆囊切除术50例为对照组,比较两组的手术时间、术中出血量、术中有无副损伤、术后疼痛程度、术后肠功能恢复时间、术后并发症发生率及术后住院时间等指标。结果两组手术均顺利完成,单孔组与对照组平均手术时间分别为(65.20±28.75)min和(61.50±21.00)min,两组间差异无统计学意义(P>0.05);两组术中出血量、术后住院时间均无统计学差异(P>0.05);两组术后肠功能恢复时间分别为(22.76±4.22)h和(28.02±5.04)h,单孔组早于对照组(P<0.05)。单孔组术后疼痛程度明显低于对照组(P<0.05)。两组术中均无副损伤,术后均无出血、胆瘘等并发症发生。结论经脐单孔腹腔镜与传统腹腔镜胆囊切除术相比,具有术后疼痛轻、恢复快、腹部瘢痕不明显且隐避等优点,是安全、可行且更加微创的手术。

Objective To compare the clinical efficacy of transumbilical single port laparoscopic cholecystectomy（TUSPLC） and conventional laparoscopic cholecystectomy（LC）,and to explore the safety,feasibility and characteristics of transumbilical single port laparoscopic cholecystectomy.Methods Fifty patients undergoing transumbilical single port laparoscopic cholecystectomy（single port group）,and fifty patients undergoing traditional laparoscopic cholecystectomy by the same surgeon（control group）,were enrolled in this study.The operation time,the operative bleeding volume,the side injury during operation,the degree of postoperative pain,the postoperative intestinal function recovery time,the postoperative complications and the postoperative hospitalized day were recorded and compared.Results All patients successfully completed the surgery.In single port group and control group the operation time was（65.20±28.75）and（61.50±21.00）min,respectively（P〉0.05）.Intraoperative blood loss,postoperative hospital stay were also not statistically different between 2 groups（P〉0.05）.The postoperative intestinal function recovery time in single port group was significantly shorter than in control group [（22.76±4.22）h vs（28.02±5.04）h,P〈0.05].The degree of postoperative pain was lower in single port group than that of control group（P〈0.05）.No side injury,postoperative bleeding and complications were found in two groups.Conclusion Transumbilical single port laparoscopic cholecystectomy is a safe,feasible and more minimally invasive way,with the advantages of less postoperative pain,quicker recovery,and no obvious abdominal scar.