三孔法在腹腔镜胃袖状切除术中的应用

Three-port approach for laparoscopic sleeve gastrectomy

目的:初步探讨三孔法腹腔镜胃袖状切除术(three-port laparoscopic sleeve gastrectomy, TPLSG)的可行性、安全性及短期临床疗效。方法:回顾性分析我院普外科2018年1月至7月接受腹腔镜胃袖状切除术(laparoscopic sleeve gastrectomy, LSG)的病人共39例,其中20例为TPLSG,19例常规五孔LSG。比较两种手术方式的手术时间、术中出血量、手术相关并发症发生率、术后疼痛程度、术后住院时间以及术后3个月多余体重减少率(excess weight loss,%EWL)。结果:TPLSG组术后疼痛程度和术后出院时间均少于常规五孔LSG组,差异有统计学意义(P<0.05),两组的手术时间、术中出血量、手术相关并发症发生率、术后3个月%EWL的差异均无统计学意义(P>0.05)。结论:TPLSG是一种安全有效的手术方式,其临床效果安全有效,可加快病人康复,缩短住院时间。

Objective To preliminarily evaluate the feasibility, safety and short-term clinical efficacy of three-port laparoscopic sleeve gastrectomy(TPLSG). Methods The clinical data of 39 patients performed laparoscopic sleeve gastrectomy(LSG) between January and July 2018 in our hospital were analyzed retrospectively. There were 20 patients with TPLSG and 19 patients with routine five-port LSG. The operative time and blood lost, surgical complications, postoperative pain and hospital stay, percentage of excess weight loss at 3 months postoperatively were compared between TPLSG and LSG. Results Less postoperative pain and reduced postoperative hospital stay in TPLSG group were found when compared with those in LSG group(P <0.05). There was no significant difference in operative time, operative blood loss, surgical complications and percentage of excess weight loss at 3 months postoperatively between two groups(P >0.05). Conclusions TPLSG would be a safe and effective surgical procedure which could accelerate the perioperative recovery and reduce hospital length of stay.