专利超微创一体化器械辅助两孔LC与传统LC临床对比分析  

Clinical comparative analysis between patented ultra-minimally invasive integrated instrument assisted two-port laparoscopic cholecystectomy and traditional laparoscopic cholecystectomy

作　　者：王云峰 张春辉[1] 夏俊伟 吴佳鹏 周德仁 顾纯炜 程庆保 姜小清 WANG Yunfeng;ZHANG Chunhui;XIA Junwei;WU Jiapeng;ZHOU Deren;GU Chunwei;CHENG Qingbao;JIANG Xiaoqing(Department of General Surgery,Shanghai Pudong New Area People’s Hospital,Shanghai 201299,China;Department of Biliary Surgery,the Third Affiliated Hospital of Naval Medical University,Shanghai 200438,China)

机构地区：[1]上海市浦东新区人民医院普外科,上海201299 [2]海军军医大学第三附属医院胆道外科,上海200438

出　　处：《肝胆胰外科杂志》2024年第12期723-728,共6页Journal of Hepatopancreatobiliary Surgery

基　　金：上海市浦东新区卫生系统学科带头人培养计划资助项目(PWRd2021-16)。

摘　　要：目的介绍并探讨专利超微创一体化器械辅助两孔腹腔镜胆囊切除术(LC)的临床应用价值。方法回顾性分析2023年3月至9月上海市浦东新区人民医院施行手术的100例胆囊疾病患者的临床资料,其中一体化器械辅助两孔组采用超微创一体化器械辅助两孔LC(n=50),传统三孔组采用传统三孔LC(n=50),比较两组手术时间、术中出血量、术后6 h和24 h疼痛评分、术后镇痛药的使用、住院时间、住院费用、手术并发症率以及患者对手术切口的满意程度等多个方面。结果两组患者均手术成功,与传统三孔组比较,一体化器械辅助两孔组手术时间缩短[(37.56±3.89)min vs(42.74±6.45)min,P<0.001],术后6 h VAS疼痛评分[(2.96±0.73)vs(3.37±0.81),P<0.05]及术后镇痛药的使用[5(10%)vs 13(26%),P<0.05]均降低,两组在术中出血量、术后24 h VAS疼痛指数、住院费用、术后引流量以及住院时间等各项指标上,差异无统计学意义(P>0.05),而术后患者对切口的满意度[(97.52±1.72)vs(95.30±1.93),P<0.001]明显升高。随访2~3个月,未发现任何胆汁渗漏、出血、腹水积聚或伤口感染等并发症。结论专利超微创一体化器械辅助两孔LC术具有切口小、损伤低、术后恢复快和疼痛轻等优势,与单通道腹腔镜胆囊切除术和2.4 mm的Minilap器械相比在成本上更具优势,并且有更好的安全性和操控性。Objective To introduce and explore the clinical application value of a patented ultra-minimally invasive integrated instrument assisted two-port laparoscopic cholecystectomy(LC).Methods A retrospective analysis was conducted on the clinical data of 100 patients with gallbladder disease at Shanghai Pudong New Area People’s Hospital between Mar.2023 and Sep 2023,50 patients treated with ultra-minimally invasive integrated instrument assisted two-port LC and 50 patients underwent traditional three-port LC.The operation time,intraoperative blood loss,6 h and 24 h VAS postoperative pain score,the use of postoperative analgesics,hospitalization time,hospitalization cost,postoperative complication rate and patients’satisfaction with surgical incision were compared between the two groups.Results The operations were successfully completed in both groups.Compared with the traditional three-port group,the operation time of the two-port group assisted by ultra-minimally invasive integrated instrument was shortened[(37.56±3.89)min vs(42.74±6.45)min,P<0.001],6 h postoperative VAS pain score[(2.96±0.73)vs(3.37±0.81).P<0.05]and the use of postoperative analgesics[5(10%)vs 13(26%),P<0.05]were lower.There was no significant difference between the two groups in intraoperative blood loss,24 h postoperative VAS pain score,hospitalization cost,postoperative drainage volume and hospitalization time(P>0.05).However,the postoperative satisfaction of patients with incision was significantly increased[(97.52±1.72)vs(95.30±1.93),P<0.001].No complications such as bile leakage,bleeding,ascites accumulation or wound infection were found during 2 to 3 months of follow-up.Conclusion Patented ultra-minimally invasive integrated instruments assisted two-port LC has many advantages,such as smaller incision,less injury,quicker recovery and lighter pain.Compared with single-channel laparoscopic cholecystectomy and the 2.4 mm Minilap device,it is more cost-effective and has better safety and handling.

关 键 词：腹腔镜胆囊切除术 两孔法腹腔镜手术 超微创一体化器械 

分 类 号：R657.4[医药卫生—外科学]