Background：Recently,the most common incision for kidney transplantation （KT） is an inverted J-shaped incision known as the ＆quot;hockey-stick.＆quot; However,demands for minimally invasive surgery in KT are increa...Background：Recently,the most common incision for kidney transplantation （KT） is an inverted J-shaped incision known as the ＆quot;hockey-stick.＆quot; However,demands for minimally invasive surgery in KT are increasing as in other various fields of surgery.Hence,we evaluated whether there is difference between minimal skin incision technique in kidney transplantation （MIKT） and conventional KT （CKT）.Methods：Between June 2006 and March 2013,a total of 452 living kidney transplant patients were enrolled.The MIKT group included 17 young unmarried women whose body mass index was 〈25 kg/m^2 and had no anatomic variation.The CKT group included 435 patients.The MIKT operation technique restricted to the 10 cm-sized skin incision in the lower right abdomen from laterally below the anterior superior iliac spine to the midline just above the pubis was performed.We compared the baseline clinical characteristics and postoperative results between two groups.For proper comparison,propensity score matching was implemented.Results：There was no difference in graft function,survival,and postoperative complication rate between MIKT and CKT groups （all P 〉 0.05）.The 5-year graft survival was 92.3% and 85.7% in MIKT and CKT groups,respectively （P =0.786）.Conclusions：Our results indicated that MIKT showed more favorable cosmetic results,and there were no statistical differences in various postoperative factors including graft function,survival,and complications compared with CKT.Hence,we suggested that MIKT is an appropriate method for selected patients in living KT.展开更多
目的:总结使用常规器械行经脐腹腔镜技术在腹部手术中的应用价值与前景。方法:回顾2012年5月至2015年1月施行的107例常规器械经脐单孔腹腔镜手术患者的临床资料,分析手术技巧及术后患者恢复情况。结果:2例胆囊切除患者局部致密粘连,胆...目的:总结使用常规器械行经脐腹腔镜技术在腹部手术中的应用价值与前景。方法:回顾2012年5月至2015年1月施行的107例常规器械经脐单孔腹腔镜手术患者的临床资料,分析手术技巧及术后患者恢复情况。结果:2例胆囊切除患者局部致密粘连,胆囊三角解剖困难,于剑突下增加5 mm Trocar,中转为两孔法腹腔镜手术;105例患者顺利完成单孔手术,无腹腔内出血、切口感染、穿刺孔疝等并发症发生,脐周切口疼痛轻微,腹壁几乎见不到疤痕。结论:严格筛选病例,使用常规器械行经脐单孔腹腔镜手术安全、可行,美容效果突出,疼痛轻微,值得临床推广应用。展开更多
目的:评价经脐单孔腹腔镜与传统腹腔镜胆囊切除术治疗胆囊良性疾病有效性及安全性。方法:计算机检索Pub Med、CNKI、万方全文数据库、中国生物医学文献数据库等,检索有关经脐单孔腹腔镜与传统腹腔镜胆囊切除术治疗胆囊良性疾病的随机对...目的:评价经脐单孔腹腔镜与传统腹腔镜胆囊切除术治疗胆囊良性疾病有效性及安全性。方法:计算机检索Pub Med、CNKI、万方全文数据库、中国生物医学文献数据库等,检索有关经脐单孔腹腔镜与传统腹腔镜胆囊切除术治疗胆囊良性疾病的随机对照试验(RCT),在客观评价文献质量后采用Rev Man 5.0进行Meta分析。结果:共纳入15篇文献,共2039例患者。Meta分析结果显示:经脐单孔腹腔镜组在术中出血量[WMD=-1.01,95%CI=(-2.77,0.74),P=0.26]、手术总并发症发生率[RR=1.29,95%CI=(0.90,1.85),P=0.17]和术后切口感染发生率[RR=1.05,95%CI=(0.44,2.51),P=0.91]与传统腹腔镜组效果相当;评估术后胃肠功能恢复时间[SMD=-0.49,95%CI=(-0.90,-0.08),P=0.02]和患者对切口满意度[SMD=1.01,95%CI=(-0.43,1.60),P=0.0007]均优于传统腹腔镜组;而传统腹腔镜的手术时间却优于经脐单孔腹腔镜[WMD=17.21,95%CI=(12.25,22.18),P<0.0001]。结论:经脐单孔腹腔镜和传统多孔腹腔镜胆囊切除术应用于胆囊良性疾病治疗都是安全有效的,但前者较传统多孔腹腔镜有一定优势,值得临床推广应用。展开更多
文摘Background：Recently,the most common incision for kidney transplantation （KT） is an inverted J-shaped incision known as the ＆quot;hockey-stick.＆quot; However,demands for minimally invasive surgery in KT are increasing as in other various fields of surgery.Hence,we evaluated whether there is difference between minimal skin incision technique in kidney transplantation （MIKT） and conventional KT （CKT）.Methods：Between June 2006 and March 2013,a total of 452 living kidney transplant patients were enrolled.The MIKT group included 17 young unmarried women whose body mass index was 〈25 kg/m^2 and had no anatomic variation.The CKT group included 435 patients.The MIKT operation technique restricted to the 10 cm-sized skin incision in the lower right abdomen from laterally below the anterior superior iliac spine to the midline just above the pubis was performed.We compared the baseline clinical characteristics and postoperative results between two groups.For proper comparison,propensity score matching was implemented.Results：There was no difference in graft function,survival,and postoperative complication rate between MIKT and CKT groups （all P 〉 0.05）.The 5-year graft survival was 92.3% and 85.7% in MIKT and CKT groups,respectively （P =0.786）.Conclusions：Our results indicated that MIKT showed more favorable cosmetic results,and there were no statistical differences in various postoperative factors including graft function,survival,and complications compared with CKT.Hence,we suggested that MIKT is an appropriate method for selected patients in living KT.
文摘目的:总结使用常规器械行经脐腹腔镜技术在腹部手术中的应用价值与前景。方法:回顾2012年5月至2015年1月施行的107例常规器械经脐单孔腹腔镜手术患者的临床资料,分析手术技巧及术后患者恢复情况。结果:2例胆囊切除患者局部致密粘连,胆囊三角解剖困难,于剑突下增加5 mm Trocar,中转为两孔法腹腔镜手术;105例患者顺利完成单孔手术,无腹腔内出血、切口感染、穿刺孔疝等并发症发生,脐周切口疼痛轻微,腹壁几乎见不到疤痕。结论:严格筛选病例,使用常规器械行经脐单孔腹腔镜手术安全、可行,美容效果突出,疼痛轻微,值得临床推广应用。
文摘目的:评价经脐单孔腹腔镜与传统腹腔镜胆囊切除术治疗胆囊良性疾病有效性及安全性。方法:计算机检索Pub Med、CNKI、万方全文数据库、中国生物医学文献数据库等,检索有关经脐单孔腹腔镜与传统腹腔镜胆囊切除术治疗胆囊良性疾病的随机对照试验(RCT),在客观评价文献质量后采用Rev Man 5.0进行Meta分析。结果:共纳入15篇文献,共2039例患者。Meta分析结果显示:经脐单孔腹腔镜组在术中出血量[WMD=-1.01,95%CI=(-2.77,0.74),P=0.26]、手术总并发症发生率[RR=1.29,95%CI=(0.90,1.85),P=0.17]和术后切口感染发生率[RR=1.05,95%CI=(0.44,2.51),P=0.91]与传统腹腔镜组效果相当;评估术后胃肠功能恢复时间[SMD=-0.49,95%CI=(-0.90,-0.08),P=0.02]和患者对切口满意度[SMD=1.01,95%CI=(-0.43,1.60),P=0.0007]均优于传统腹腔镜组;而传统腹腔镜的手术时间却优于经脐单孔腹腔镜[WMD=17.21,95%CI=(12.25,22.18),P<0.0001]。结论:经脐单孔腹腔镜和传统多孔腹腔镜胆囊切除术应用于胆囊良性疾病治疗都是安全有效的,但前者较传统多孔腹腔镜有一定优势,值得临床推广应用。
