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首页> 外文期刊>Surgical Endoscopy >Randomized clinical study for assessment of incision characteristics and pain associated with LESS versus laparoscopic cholecystectomy.
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Randomized clinical study for assessment of incision characteristics and pain associated with LESS versus laparoscopic cholecystectomy.

机译：评估LESS与腹腔镜胆囊切除术相关的切口特征和疼痛的随机临床研究。

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Laparoendoscopic single-site surgery (LESS) has emerged as a technique that uses a natural scar, the umbilicus, within which a multiple-entry portal is placed into a 3.0-4.0-cm single incision to perform operations. The objective of this study was to compare incision size, wound complications, and postoperative pain of LESS compared with those of laparoscopic cholecystectomy (LC).A prospective randomized controlled study was conducted between January and June 2011 at two university hospitals in Rio de Janeiro, Brazil. Fifty-seven patients were randomly assigned to undergo laparoscopic or LESS cholecystectomy. Skin and aponeurosis wound sizes were recorded. A 10-point visual analog scale (VAS) was used to assess pain at postoperative hours 3 and 24. Healing and wound complications were assessed at follow-up.A total of 57 patients, 53 women and 4 men with a mean age of 48.7 years, were randomly assigned to undergo LESS (n = 28) or LC (n = 29). The mean length of the umbilical skin incision was 4.0 cm (range = 2.1-5.8) in LESS and 2.7 cm (1.5-5.1) in LC (p < .0001). The mean internal aponeurosis diameter was 3.5 cm (2.0-5.5) in LESS and 2.3 cm (1.2-3.5) in LC (p < .0001). The mean operative time was 60.3 min (32-128) for LESS and 51.3 min (25-120) for LC (p = 0.11). Gallbladder perforation at detachment occurred in 15.69 % of the LESS cases and in 5.88 % of the LC cases (p = 0.028). The mean VAS score for pain at hour 3 was 2.0 points (0-7) for the LESS group and 4.0 (0-10) for the LC group (p = 0.07), and at postoperative hour 24 it was 0.3 points (0-6) for LESS and 2.3 (0-10) for LC (p = 0.03). There were no significant differences in wound complications. Incisional hernias were not found in either group.The LESS single-port (SP) operations demand a bigger incision than LC surgery. However, there were no differences in healing, wound infections, and hernia development. We found a tendency of less postoperative pain associated with LESS/SP than with LC.
机译：腹腔镜单部位手术（LESS）作为一种使用自然疤痕的技术而出现，脐部将一个多入口门置于3.0-4.0-cm单切口中以进行手术。这项研究的目的是比较LESS的切口大小，伤口并发症和术后疼痛与腹腔镜胆囊切除术（LC）的比较。一项前瞻性随机对照研究于2011年1月至6月在里约热内卢的两家大学医院进行，巴西。五十七例患者被随机分配接受腹腔镜或LESS胆囊切除术。记录皮肤和腱膜伤口的大小。术后3和24小时使用10点视觉模拟量表（VAS）评估疼痛。随访时评估愈合和伤口并发症。共有57例患者，53名女性和4名男性，平均年龄为48.7岁年，随机分配接受LESS（n = 28）或LC（n = 29）。在LESS中，脐带皮肤切口的平均长度为4.0 cm（范围= 2.1-5.8），在LC中为2.7 cm（1.5-5.1）（p <.0001）。 LESS的平均内部腱膜直径为3.5 cm（2.0-5.5），LC的平均内部腱膜直径为2.3 cm（1.2-3.5）（p <.0001）。 LESS的平均手术时间为60.3分钟（32-128），而LC的平均手术时间为51.3分钟（25-120）（p = 0.11）。 LESS病例中有15.69％的患者发生了胆囊穿孔，LC病例中有5.88％的患者发生了胆囊穿孔（p = 0.028）。 LESS组在第3小时疼痛的平均VAS评分为2.0分（0-7），LC组为4.0（0-10）（p = 0.07），术后24小时为0.3分（0-对于LESS为6），对于LC为2.3（0-10）（p = 0.03）。伤口并发症无明显差异。两组均未发现切口疝.LESS单端口（SP）手术需要比LC手术更大的切口。但是，愈合，伤口感染和疝气的形成没有差异。我们发现，与LESS / SP相比，LESS / SP的术后疼痛有减轻的趋势。

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