改良器械和常规器械经脐入路单孔腹腔镜胆囊切除术的对比分析

Comparative analysis of modified instruments and conventional instruments in transumbilical single-pore laparoscopic cholecystectomy

目的探讨改良器械和常规器械经脐入路单孔腹腔镜胆囊切除术的临床应用效果。方法选取行常规器械和改良器械经脐入路单孔腹腔镜胆囊切除术患者各50例（常规器械组和改良器械组），比较两组手术时间、脐部戳口恢复满意度、术中出血、术后并发症、手术方式更改率、住院时间及住院费用。结果改良器械组手术时间、手术方式更改率低于常规器械组，脐部戳口恢复满意度高于常规器械组[（43.5 ± 12.0）min比（60.0 ± 2.2）min、2.0%（1/50）比12.0% （6/50）、（4.5 ± 0.2）分比（3.2 ± 1.2）分]，差异有统计学意义（P〈0.05）。但两组术中出血量、术后并发症、住院时间及住院费用比较差异无统计学意义（P〉0.05）。结论改良器械较常规器械经脐入路单孔腹腔镜胆囊切除术可明显减少手术时间和手术方式更改率，并提高脐部戳口恢复满意度，降低术者的操作难度，缩短学习曲线。

Objective To analyze the effect of clinical application of transumbilical single-pore laparoscopic cholecystectomy with modified instruments and conventional instruments. Methods Fifty transumbilical single-pore laparoscopic cholecystectomy patients with conventional instruments （conventional instruments group） and 50 transumbilieal single-pore laparoscopic cholecystectomy patients with modified instruments （modified instruments group） were selected. The operation time, recovery satisfaction degree of navel incision, intraoperative bleeding, postoperative complication, change rate of surgical procedure, length of hospital stay and hospitalization expenses were compared between 2 groups. Results The operation time and change rate of surgical procedure in modified instruments were significantly lower than those in conventional instruments, and the recovery satisfaction degree of navel incision was significantly higher than that in conventional instruments： （43.5 ± 12.0） min vs. （60.0 ± 2.2） min, 2.0% （1/50） vs. 12.0% （6/50） and （4.5 ± 0.2） scores vs. （3.2± 1.2） scores, and there were statistical differences （P 〈 0.05）. There were no statistical differences in intraoperative bleeding, postoperative complication, length of hospital stay and hospitalization expenses between 2 groups （P〉 0.05）. Conclusions The transumbilical single-pore laparoseopic cholecystectomy with modified instruments can obviously reduce the operation time and the change rate of surgical procedure, improve the recovery satisfaction degree of navel incision, reduce the operation difficulty of performer and shorten the time of learning curve.