经脐单孔腹腔镜与常规腹腔镜胆囊切除术的对比研究

Comparative study on trans-umbilical single port laparoscopic and conventional laparoscopic cholecystectomy

目的:比较单孔腹腔镜胆囊切除术与常规腹腔镜胆囊切除术的手术疗效,探讨经脐单孔腹腔镜胆囊切除术的安全性、可行性及优点。方法:将46例施行单孔腹腔镜胆囊切除术患者设为实验组,另将43例由同组手术医师同期施行常规腹腔镜胆囊切除术患者设为对照组,比较两组手术时间、术中出血量、术后首次下床活动时间、术后疼痛评分、住院时间、术后30 d瘢痕可见度及术后并发症发生率等指标。结果:两组患者均顺利完成手术,无术后并发症发生;实验组术后疼痛评分、术后首次下床活动时间、术后30 d瘢痕可见度低于对照组,两组比较差异有统计学意义(P<0.05);而手术时间、术中出血量、住院天数、切口感染率、切口疝发生率两组比较无统计学差异(P>0.05)。结论:单孔腹腔镜胆囊切除术具有术后疼痛轻、瘢痕隐蔽、美容效果好的优势,适合在临床推广应用。

Objective： To compare the efficacy of single port laparoscopic cholecystectomy with that of conventional laparoscopic cholecystectomy and study the safety,feasibility and advantages of trans-umbilical single port laparoscopic cholecystectomy. Methods： 46 patients who underwent single port laparoscopic cholecystectomy were taken as the experimental group and other 43 patients undergoing conventional laparoscopic cholecystectomy were taken as the control group. The duration of operation,volume of intraoperative bleeding,ambulation time after operation,postoperative pain score,hospitalization time,visibility of scar after operation for 30 days and the incidence of postoperative complications were compared between the two groups. Results： All operations were successfully performed and no complication occurred in the patients of the two groups. The postoperative pain score,ambulation time after operation and the visibility of scar after operation for 30 days were lower and shorter in the experimental group than the control group（ P〈0. 05）; there were no statistically significant differences in the comparison of the duration of operation,volume of intraoperative bleeding,hospitalization days,the infection rate of incision and the incidence of incisional hernia between the two groups（ P〉0. 05）. Conclusion： The single port laparoscopic cholecystectomy has the advantages of less postoperative pain,hidden scars and good cosmetic effect.