单孔腹腔镜与传统腹腔镜胆囊切除术治疗效果比较  

A prospective randomized controlled trial： single-incision laparoscopic cholecystectomy vs.traditional three-port laparoscopic cholecystectomy

作　　者：吴万庆[1] 傅聿铭[1] 郭晓磊[1] 郭魁元[1] 崔小兵[1] 

机构地区：[1]郑州大学第五附属医院普外科,450052

出　　处：《中华实验外科杂志》2015年第1期160-162,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 探讨单孔腹腔镜（SILC）与传统腹腔镜两种术式的安全性和可行性.方法 选取胆囊疾病患者54例随机分为SILC组（n=26）和三通道腹腔镜胆囊切除术（3PLC）组（n=28）.收集患者年龄、体质量、身高、体质量指数（BMI）、手术时间、疼痛分数、中途转换手术率、切口满意度评分等临床资料,并进行了12个月的随访.结果 两组患者在性别、年龄、体质量、身高和BMI方面比较差异无统计学意义（P＞0.05）.SILC组手术时间长于3PLC组[（56.9 ±15.8） min比（35.2±8.7） min,P＜0.01].应用相同的麻醉药品后SILC组在术后第1天较3PLC组疼痛分数更高,总的疼痛分数两者相似,差异无统计学意义（P＞0.05）.SILC组患者术后伤口并发症发生率更高,但术后疝发生率相同.SILC组切口满意度评分分数更高[（11.7±0.8）分比（10.1±1.2）分,P＜0.05].结论 SILC较3PLC治疗单纯胆道疾病安全、有效.Objective To evaluate the clinical efficacy and safety of single-incision laparoscopic cholecystectomy （SILC） compared with conventional three-port laparoscopic cholecystectomy （3PLC）.Methods Fifty-four patients diagnosed with biliary deases were included in this study at our institution.The patients were randomized into two groups：3PLC group （n =28） and SILC group （n =26）.Data including gender,age,weight,height,body mass index,operative duration,pain scores,percentage of conversion during the operation and vancouver scar scale were prospectively collected and analyzed.Patients were prospectively collected and analyzed.Patients were followed up for 12 months.Results There were no significant differences between the two groups with respect to gender,age,weight,height and body mass index.The operation time in SILC group was significantly longer than that in 3PLC group [（56.9 ± 15.8） min vs.（35.2 ± 8.7） min,P 〈 0.01].On the first day after operation,the pain scores were higher for SILC with the application of equal narcotic drugs.There were no statistically signiicnat differences between the two groups in terms of total pain scores.Wound complications were severer in SILC,but there was no significant difference in incidence of incision hernia between the two groups.Cosmetic scores were favored for SILC （11.7 ± 0.8 vs.10.1 ± 1.2,P 〈 0.05）.Conclusion This prospective randomized controlled study showed that SILC is safe and feasible in treating patients with simple biliary diseases compared with 3PLC.

关 键 词：胆囊切除术 腹腔镜 

分 类 号：R657.4[医药卫生—外科学]