兰州大学机构库 >学院待认领
单孔与三孔腹腔镜胆囊切除术的对比研究
Alternative TitleOne-port vs three-port laparoscopic cholecystectomy
张振名
Thesis Advisor高鹏
2011-05-25
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword胆囊切除术 腹腔镜/方法 单孔法 三孔法 对比研究
Abstract目的:腹腔镜胆囊切除术(Laparoscopic cholecystectomy LC)是治疗胆囊良性疾病的金标准。近年来单孔腹腔镜胆囊切除术(laparoendoscopic single site surgery LESS)受到普外科医师的普遍关注。然而与三孔LC相比,LESS技术有哪些优势,目前尚无随机对照实验证实。本项研究采用随机对照的方法对LESS和三孔LC进行比较,评价LESS的安全性和可行性。 方法:2009年9月-2010年4月在甘肃省人民医院腹腔镜中心接受择期腹腔镜胆囊切除术的96例胆囊良性病患者,被随机分为两组,单孔组(48例)和三孔组(48例)。记录两组患者的基础资料(性别、年龄、体重指数、ASA评分)、手术适应症;比较两组手术时间、术中估计失血量、术后疼痛程度(VAS评分)、术后镇痛剂用量、术中及术后并发症、胃肠功能恢复时间、术后住院时间、患者对切口疤痕的满意程度。 结果:两组之间性别、年龄、体重指数、ASA评分、手术适应症、术中估计失血量、术中及术后并发症无统计学差异,手术时间单孔组较三孔组长,单孔组后16例较前32例手术时间短,术后6、12、24、36小时时单孔组较三孔组疼痛轻,术后胃肠功能恢复时间单孔组较三孔组短,单孔组较三孔组术后住院时间短、单孔组较三孔组对术后切口疤痕满意程度打分高。 结论:对于单纯的胆囊良性疾病(包括胆囊结石、胆囊息肉),经脐单孔腹腔镜胆囊切除术是安全可行的,且术后疼痛轻,胃肠功能恢复快,更美观,可以替代部分三孔腹腔镜胆囊切除术。
Other AbstractAim: Laparoscopic cholecystectomy (LC) is the gold-standard for the treatment of benign disease of the gallbladder. In recent years laparoendoscopic single site surgery (LESS) has gained greater interest among the general sugeons. However, no randomized controlled trials are present in the literature that confirm the clinical advantages of LESS compared with the classic laparoscopic procedures. For this reason, we present the preliminary results of this randomized prospective study regarding the feasibility and safety of LESS cholecystectomy versus classic laparoscopic technique. To evaluate the safety and feasibility of transumbilical single-incision laparoscopic cholecystectomy. Methods: From September 2009 to April 2010, 96 patients were randomly assigned to three-port classic laparoscopic cholecystectomy groups(n =48) or LESS groups (n =48). All the patients’ basic details were recorded: gender, age, body mass index, ASA grade and indication of operation. Their operative time, estimated blood loss during operation, abdominal postoperative pain at 6h, 12h, 24h, 36h after operation, usage of analgesic, complication during and after operation, functional rehabilitation time of gastrointestinal tract, postoperative hospitalized time and wound satisfaction score were constrasted. Results: No differences were registered between the two groups about gender, age, BMI,ASA grade,indications of operation, estimated blood loss during operation, complications during and after operation. operative time was significantly longer in LESS procedures, operative time of the previous 32 patients was longer than the latter 16 patients in LESS group. Abdominal postoperative pain was significantly lighter in LESS cholecystectomy at 6h,12h,24h after operation, compare to three-port classic laparoscopic cholecystectomy groups, usage of analgesic was less in LESS groups.As to hospital stay, LESS groups was significantly shorter than three-port classic laparoscopic cholecystectomy groups. Wound satisfaction score showed statistically significant differences between the two groups: in LESS group, patients were more satisfied with the presence of a small scar. Conclusions: Laparoendoscopic single site surgery (LESS) cholecystectomy is safe and feasible for patients with uncomplicated gallbladder disease, It has the advantages of mini invasion,light postoperative pain, rapid recovery, shorter hospital stay,more beautiful than conventional laparoscopic cholecystectomy,and ...
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/223665
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
张振名. 单孔与三孔腹腔镜胆囊切除术的对比研究[D]. 兰州. 兰州大学,2011.
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