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首页> 外文期刊>Surgical Endoscopy >Optimized transumbilical endoscopic cholecystectomy: a randomized comparison of two procedures.
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Optimized transumbilical endoscopic cholecystectomy: a randomized comparison of two procedures.

机译：优化的经脐内镜胆囊切除术：两种程序的随机比较。

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BACKGROUND: Natural orifice transluminal endoscopic surgery (NOTES) and transumbilical endoscopic surgery (TUES) are being developed to improve minimally invasive surgery further. In 2006, the authors developed TUES using a single triple-channel trocar or single-trocar (ST) technique. To minimize the risk and improve the surgical efficiency further, the procedure was optimized using a two-trocar (TT) technique, with both trocars in the umbilicus. This study compared the clinical results for the TT and ST techniques. METHODS: For this study, 32 patients with chronic gallbladder disease and indications for cholecystectomy were randomly assigned to undergo surgery with either the TT technique (17 patients) or the ST technique (15 patients). With the TT procedure, two modified 5-mm trocars with small handles were inserted through the navel, one above and one below the umbilicus. Another 2-mm trocar was inserted for a grasper in the right upper abdomen. With the ST procedure, one 15-mm umbilical incision was made for insertion of a previously developed triple-channel trocar to apply the laparoscope, grasper, and dissector individually. Operation time, postoperative hospital stay, and postoperative pain were compared between the two procedures. RESULTS: The mean operative time was significantly shorter with the TT technique (35.71 +/- 9.74 min) than with the ST technique (125.25 +/- 18.9 min (p < 0.001). Use of analgesics after surgery also was less in the TT group than in the ST group (0 vs. 7, respectively; p < 0.05). The postoperative hospital stay did not differ significantly between the two groups (p > 0.05). CONCLUSIONS: Although both procedures were based on the transumbilical approach, the TT approach was found to be faster and less painful than the ST approach. The difference in the cosmetic result was minimal.
机译：背景：自然孔腔内镜手术（NOTES）和脐带内镜手术（TUES）正在开发中，以进一步改善微创手术。在2006年，作者使用单三通道套管针或单套管（ST）技术开发了TUES。为了最大程度地降低风险并进一步提高手术效率，使用两套管针（TT）技术对手术进行了优化，两个套管针都位于脐部。这项研究比较了TT和ST技术的临床结果。方法：本研究将32例慢性胆囊疾病和胆囊切除术的适应症患者随机分配为接受TT技术（17例）或ST技术（15例）的手术。通过TT手术，将两把改良的5毫米带小柄的套管针插入肚脐，一个放在脐上，另一个放在脐下。在右上腹部插入另一个2毫米的套管针作为抓紧器。通过ST手术，制作了一个15毫米的脐带切口，用于插入先前开发的三通道套管针，以分别应用腹腔镜，抓紧器和解剖器。比较两种手术的手术时间，术后住院时间和术后疼痛。结果：TT技术的平均手术时间（35.71 +/- 9.74分钟）显着短于ST手术的技术（125.25 +/- 18.9分钟（p <0.001）），TT手术后使用镇痛药的时间也更少结论：尽管这两种方法均基于脐带入路，但两组的术后住院时间无显着差异（p> 0.05）。发现TT法比ST法更快，更痛苦，美容效果的差异很小。

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