三孔和五孔腹腔镜胃袖状切除术的临床疗效观察

Clinical effect observation on the three-port and five-port laparoscopic sleeve gastrectomy

目的 探讨三孔腹腔镜胃袖状切除术(three-port laparoscopic sleeve gastrectomy,TPLSG)和五孔腹腔镜胃袖状切除术(five-port laparoscopic sleeve gastrectomy,FPLSG)的安全性及有效性。方法 选取2019年7月至2020年7月首都医科大学附属北京世纪坛医院接受腹腔镜胃袖状切除术患者95例,根据手术trocar孔数不同分为TPLSG组(43例)和FPLSG组(52例)。术后随访1个月,比较两组患者的术后相关情况。结果 95例患者中,男42例,女53例,年龄19~64岁,平均(31.0±10.0)岁。按照1∶1匹配,每组各37例配对成功,匹配后两组的基线资料差异无统计学意义(P>0.05)。所有患者均顺利完成手术。两组患者手术时间、术中失血量、术后住院时间、住院费用、首次排气时间、开始流质饮食时间、额外体重丢失比例(excess weight loss%,EWL%)、术后并发症发生率及其缓解率的比较,差异均无统计学意义(P>0.05);术后1个月随访,TPLSG组术后疼痛、美观及总体满意度高于FPLSG组,差异均有统计学意义(P<0.05)。结论 TPLSG和FPLSG同样安全、有效,其中TPLSG的切口更美观、患者疼痛更轻。

Objective To explore the safety and effectiveness of three-port laparoscopic sleeve gastrectomy(TPLSG) and five-port laparoscopic sleeve gastrectomy(FPLSG).Methods A total of 95 patients who underwent laparoscopic sleeve gastrectomy in Beijing Shijitan Hospital affiliated to Capital Medical University from July 2019 to July 2020 were selected,and were divided into TPLSG group(43 cases) and FPLSG group(52 cases) according to the number of trocar holes.The patients were followed up for one month after operation,the postoperative related conditions of the two groups were compared.Results Among the 95 patients,there were 42 male and 53 female,aged from 19 to 64 years,with an average of(31.0 ± 10.0) years.According to 1∶1 matching,37 cases in each group were matched successfully,and there were no statistical differences in baseline information between the two groups after matching(P>0.05).All patients completed the surgery successfully.There were no statistically significant differences between the two groups in operation time,intraoperative blood loss,postoperative hospitalization time,hospitalization expenses,first exhaust time,time to start liquid diet,excess weight loss% ratio(EWL%),incidence of postoperative complications and their remission rates(all P>0.05).At one month postoperative follow-up,the postoperative pain,aesthetics and overall satisfaction in the TPLSG group were higher satisfied than those of the FPLSG group,and the differences were statistically significant(all P<0.05).Conclusions TPLSG is as safe and effective as FPLSG,and TPLSG is feasible with a more aesthetic and less painful incision.