单孔腹腔镜与传统腹腔镜胆囊切除对胆囊良性疾病的疗效对比分析

Clinical outcomes of single-incision laparoscopic cholecystectomy versus 3-port laparoscopic cholecystectomy

目的比较单孔腹腔镜胆囊切除术(single-incision laparoscopic cholecystectomy,SILC)与传统三孔腹腔镜胆囊切除术(three port laparoscopic cholecystectomy,TPLC)治疗胆囊良性疾病的安全性及有效性。方法我科于2011年6月至2013年4月因胆囊良性疾病行腹腔镜胆囊切除术116例,其中45例患者行SILC,71例患者行TPLC,对比分析两组患者手术时间、术中出血量、术后住院时间、并发症发生率、疼痛评分、中转开腹率和美容效果满意度。结果两组患者年龄、性别、体质量指数等方面比较差异无统计学意义(P>0.05)。SILC组患者手术时间明显长于TPLC组(P<0.05);SILC组与TPLC组术中出血量比较差异无统计学意义(P>0.05);两组患者术后住院时间比较差异无统计学意义(P>0.05);术后第1天疼痛评分SILC组明显高于TPLC组(P<0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。SILC组美容效果满意度明显高于TPLC组(P<0.05)。结论单孔腹腔镜胆囊切除术治疗胆囊良性疾病安全、有效,较传统三孔腹腔镜胆囊切除术美容效果好,但手术时间稍长于传统腹腔镜手术。

Objective To evaluate the safety and efficacy of single-incision laparoscopic cholecystectomy( SILC) versus 3- port laparoscopic cholecystectomy( TPLC) in the treatment of benign gallbladder diseases. Methods A total of 116 patients with benign gallbladder diseases administered in our department from June 2011 to April 2013 were retrospectively recruited in this study. Forty-five of them undergoing SILC were assigned into group SILC,and 71 patients receiving TPLC into group TPLC. There were no significant differences in age,sex,or body mass index among the 2 groups( P > 0. 05). Operative time,blood loss, postoperative hospital stay, incidence of complications, pain score, laparotomy rate, and satisfaction with cosmetic results were analyzed and compared between the 2 groups. Results Operation time was significantly longer in the group SILC than the group( P < 0. 05). There was no statistical significances in the amount of intraoperative bleeding and postoperative staying time between the 2 groups( P > 0. 05). The pain scores were higher in the group SILC than the group TPLC in postoperative day 1( P < 0. 05),but no difference was seen in the incidence of complications. Obvious higher cosmetic satisfaction was seen in the group SILC( P <0. 05). Conclusion SILC is a safe and efficient approach for surgical treatment of benign gallbladder diseases. It is superior to TPLC because of its better cosmetic results,but takes longer of operation time.