Minilap辅助经脐单孔腹腔镜下胆囊切除术的临床应用研究
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万智恒, Email: 15849472388@163.com

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内蒙古包头市社会发展科技支撑项目(2015S2004-5-20)。


Clinical application of Minilap-assisted single-port transumbilical laparoscopic cholecystectomy
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    摘要:

    目的:探讨Minilap辅助下经脐单孔腹腔镜下胆囊切除术的可行性。 方法:随机选取2015年1月—2015年12月包头医学院第一附属医院普外一科住院胆囊结石、胆囊息肉患者40例,按照自愿的原则分为对照组与观察组,每组20例,分别行经脐单孔腹腔镜胆囊切除术(对照组)与Minilap辅助经脐单孔腹腔镜胆囊切除术(观察组)。比较两组患者的相关临床指标。 结果:40例腹腔镜手术均获成功,无中转开腹。与对照组比较,观察组平均手术时间(29.90 min vs. 19.10 min,P=0.000)与术中出血量(4.90 mL vs. 8.05 mL,P=0.000)明显减少;术后住院时间、疼痛评分、术后使用镇痛药物、对瘢痕满意度方面两组间均无统计学差异(均P>0.05)。术后随访10~18个月,患者术后恢复良好,Minilap穿刺点无明显疤痕。 结论:Minilap辅助下经脐腹腔镜胆囊切除术安全可行、术后美容效果好,降低了手术难度,值得临床应用。

    Abstract:

    Objective: To investigate the feasibility of Minilap-assisted single-port transumbilical laparoscopic cholecystectomy. Methods: Forty patients with gallbladder stones or gallbladder polyps admitted in the First Department of General Surgery of the First Affiliated Hospital, Baotou Medical College, between January and December of 2015 were randomly selected, and then divided into control group and observation group according to their preferences, with 20 cases in each group. Patients in control group underwent single-port transumbilical laparoscopic cholecystectomy and those in observation group received Minilap-assisted single-port transumbilical laparoscopic cholecystectomy. The main clinical variables between the two groups of patients were compared. Results: Laparoscopic surgery was successfully performed in all 40 patients, without any open conversion. In observation group compared with control group, the average operative time (29.90 min vs. 19.10 min, P=0.000) and intraoperative blood loss (4.90 mL vs. 8.05 mL, P=0.000) were significantly decreased, while other variables showed no significant difference (all P>0.05), including the length of postoperative hospital stay, postoperative pain scores, analgesic consumption, and degree of patient satisfaction for surgical scars. Postoperative follow-up was conducted for 10 to 18 months, all patients recovered uneventfully, and no obvious scar was noted in the puncture site of Minilap. Conclusion: Minilap-assisted single-port transumbilical laparoscopic cholecystectomy is safe and feasible, has favorable cosmetic results and it helps to reduce surgical difficulty, so it is recommended to be used in clinical practice.

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吴攀|李瑞斌|万智恒. Minilap辅助经脐单孔腹腔镜下胆囊切除术的临床应用研究[J].中国普通外科杂志,2017,26(2):166-171.
DOI:10.3978/j. issn.1005-6947.2017.02.006

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  • 收稿日期:2016-08-12
  • 最后修改日期:2017-01-15
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  • 在线发布日期: 2017-02-15