经脐单孔与三孔法腹腔镜胆囊切除术疗效对比  

Comparison of single port and three-port laparoscopic cholecystectomy

作　　者：敖锋[1] 赵中浩 古文华 罗雪涛 瞿秋耜 王殿秀 郑湘琼 AO Feng;ZHAO Zhong-hao;GU Wen-hua;LUO Xue-tao;QU Qiu-si;WANG Dian-xiu;ZHENG Xiang-qiong(Department of General Surgery,Songjiang Sijing Hospital,Shanghai 201600,China)

机构地区：[1]上海市松江区泗泾医院普外科,上海201600

出　　处：《中国临床医学》2022年第4期664-668,共5页Chinese Journal of Clinical Medicine

摘　　要：目的比较经脐单孔与三孔法腹腔镜胆囊切除术的疗效,探讨经脐单孔腹腔镜胆囊切除术(transumbilical single port laparoscopic cholecystectomy,TUSPLC)的可行性和有效性。方法回顾性分析上海市松江区泗泾医院普外科2020年3月至2021年11月接受TUSPLC的51例患者及传统三孔法腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的51例患者的临床资料。结果TUSPLC组手术时间显著长于传统三孔法LC组[(49.4±13.3)min vs(31.2±11.5)min,P=0.01];TUSPLC组增加操作孔的患者比例高于传统三孔法LC组(9.80%vs 1.96%,P=0.02)。TUSPLC组较传统三孔法LC组术后镇痛药物使用率更低(7.8%vs 33.3%,P=0.01),术后腹壁瘢痕满意度评分更高[(3.88±0.11)分vs(2.75±0.31)分,P=0.01]。TUSPLC组术中出血量、术后并发症及住院天数与传统三孔法LC组差异无统计学意义。结论与传统三孔法LC相比,TUSPLC创伤小、术后切口隐匿美观、患者满意程度高,更符合经自然腔道内镜手术(natural orifice transluminal endoscopic surgery,NOTES)理念,可在合适的患者中推广。Objective To explore the feasibility and effectiveness of transumbilical single port laparoscopic cholecystectomy(TUSPLC)by comparison of single port and three-port laparoscopic cholecystectomy.Methods The clinical data of 51 patients underwent TUSPLC and 51 patients underwent three-port laparoscopic cholecystectomy(LC)in Sijing Hospital from March 2020 to November 2021 were analyzed retrospectively.Results The operation time in the TUSPLC group was significantly longer than that in the three-port LC group([49.4±13.3]min vs[31.2±11.5]min,P=0.01),and the rate of patients increasing puncturing port in the TUSPLC group was significantly higher than that in the three-port LC group(9.80%vs 1.96%,P=0.02).Compared with the three-port LC group,postoperative analgesics were used less frequently in the TUSPLC group(7.8%vs 33.3%,P=0.01),and the postoperative abdominal scar satisfaction score was higher(3.88±0.11 vs 2.75±0.31,P=0.01).There was no significant difference in operative blood loss,postoperative complications and hospital stay between the two groups.Conclusion Compared with the traditional three-port LC,TUSPLC has the advantage of less trauma and higher patient satisfaction,and more embodies the concept of natural orifice transluminal endoscopic surgery(NOTES)at the present stage.

关 键 词：胆囊切除术 腹腔镜 经脐 单孔 

分 类 号：R657.4[医药卫生—外科学]