2mm无鞘针形器械在隐瘢痕腹腔镜胆囊切除术中的应用:一种无瘢痕手术新思路  

A new scar hidden laparoscopic cholecystectomy using 2mm instruments without Trocar

作　　者：徐安安[1] 黄安华[1] 何川琦[1] 王维东[1] 胡海[1] 

机构地区：[1]同济大学附属东方医院,上海200120

出　　处：《腹腔镜外科杂志》2012年第6期432-434,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨隐瘢痕腹腔镜胆囊切除术的手术方法及应用价值。方法:选择2011年1月至2011年6月60例无严重胆囊炎症的胆囊息肉或胆囊结石患者,随机分为2组,新方法组行隐瘢痕腹腔镜胆囊切除术,单孔组行常规单孔腹腔镜胆囊切除术,对比分析两组患者手术时间、术后切口疼痛程度、术后切口满意程度及中转率。结果:新方法组均顺利完成手术;单孔组28例顺利完成手术,2例中转常规腹腔镜胆囊切除术。新方法组与单孔组手术时间平均(14.17±3.51)min和(24.67±4.12)min,新方法组明显优于单孔组(P<0.01);术后切口疼痛程度轻于单孔组,但差异无统计学意义(P>0.05);术后患者对切口满意程度优于单孔组,差异有统计学意义(P<0.01)。两组均无出血、胆漏、胆管损伤等并发症发生。结论:隐瘢痕腹腔镜胆囊切除术安全、可行,术后瘢痕不明显且隐蔽,相对单孔腹腔镜胆囊切除术,手术时间缩短,手术难度及中转率降低,术后患者切口满意度高,为腹腔镜手术的更微创化发展提供了新的可行途径及思路。Objective：To introduce a new laparoscopic cholecystectomy and compare it with single incision laparoscopic chole cystectomy. Methods：From Jan. 2011 to Jun. 2011,30 consecutive patients who underwent a new scar hidden laparoscopic cholecystectomy （NLC group） were compared with a prospective cohort of 30 patients who underwent single incision laparoscopic cholecystectomy （SILC group） during the same period. The operation time, pain score, satisfactory score and conversion rate were recorded. Results：All operations were performed successfully in NLC group. Two patients were converted to conventional 3-port laparoscopic cholecystectomy in the SILC group. No post-operative complications occurred in both groups. The operation time was significantly less in the NLC group [ （14.17 ± 3.51 ） mini vs. （24.67 ± 4.12） rain in SILC group （P 〈 0.01 ）. As to satisfactory score, NLC group was superior to SILC group [ （4.53 ± 0.57 ） in NLC group vs. （4.07 ± 0.52） in SILC group,P 〈 0.01 ]. There was also a lower postoperative pain score in the NLC group although the results did not reach statistical significance. Conclusions：The new scar hidden laparoscopic cholecysteetomy is a safe and feasible operation. Compared with single incision laparoscopic eholecysteetomy,it has a less operation time, less difficulty and conversion rate,but a higher satisfactory score. It demonstrates a new aDDroach for minimally invasive surgery.

关 键 词：胆囊切除术 腹腔镜 单一切口 隐瘢痕 对比研究 

分 类 号：R657.4[医药卫生—外科学]