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首页> 外文期刊>Surgical Endoscopy >Three-port microlaparoscopic cholecystectomy in 159 patients.
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Three-port microlaparoscopic cholecystectomy in 159 patients.

机译：三端口微腹腔镜胆囊切除术159例。

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BACKGROUND: Laparoscopic cholecystectomy has undergone many refinements including reductions in port size and number. This study attempts to determine whether further reduction in port size from that previously reported by us can reduce postoperative pain without compromising the efficacy of the surgery. METHODS: In this study, 159 patients underwent laparoscopic cholecystectomy with three ports: one 5-mm umbilical port, one 3-mm subxiphoid port, and one 3-mm port in the right subcostal position. Data were collected prospectively for each patient on the duration of analgesic use, quantity of analgesic tablets consumed, postoperative pain, most painful incision, and days of recovery required before return to activity and work. These measures were compared with those collected from a group of 100 patients who had undergone laparoscopic cholecystectomy with three 5-mm ports in a previous study. RESULTS: Patients in the current study group required analgesics for a longer duration (4 vs 2.9 days; p = 0.001), used more analgesic tablets (10.7 vs 8.1; p = 0.007), and reported greater postoperative discomfort (5 vs 4.1; p = 0.016) as compared with all in the 5-mm port group. The 3-mm port group needed more days for recovery before leaving the house (2.9 vs 2.7; p = 0.504), but they returned to work earlier (5.1 vs 5.9; p = 0.065) than the group that had undergone cholecystectomy with three 5-mm ports, although there was not a significant difference between the groups. Operative time increased from 18.5 to 20.9 min (p = 0.054) in the group with two 3-mm ports. Five patients (3.1%) in the current group required enlargement of a port to complete the procedure, as compared with none in the comparison group. There was one complication (0.6%), as compared with two complications (2.0%) in the previous group. CONCLUSIONS: This study did not demonstrate a reduction in postoperative pain or a consistent improvement in recovery when the port size was reduced at the subcostal and subxiphoid positions. It did, however, show that ports could safely be reduced in size without a negative impact on the surgeon's ability to perform a cholecystectomy. Reducing port size can be a tool in the surgeon's armamentarium for use in the attempt to optimize cosmetic results.
机译：背景：腹腔镜胆囊切除术经历了许多改进，包括减少了端口的大小和数量。这项研究试图确定从我们先前报道的端口尺寸进一步缩小是否可以减轻术后疼痛而又不影响手术效果。方法：在本研究中，有159例患者接受了三个端口的腹腔镜胆囊切除术：一个位于右肋下位置的5 mm脐带端口，一个3 mm剑突下端口和一个3 mm端口。前瞻性收集每位患者的镇痛数据，镇痛药的用量，术后疼痛，最痛苦的切口以及恢复活动和工作所需的恢复天数。将这些测量结果与先前研究中从一组100例接受腹腔镜胆囊切除术并具有三个5毫米端口的患者中收集的测量结果进行了比较。结果：当前研究组的患者需要较长时间的镇痛药（4 vs 2.9天; p = 0.001），使用了更多的镇痛药（10.7 vs 8.1; p = 0.007），并且术后不适感更大（5 vs 4.1; p = 0.016），与5毫米端口组中的所有端口相比。 3毫米端口组在离开房屋之前需要更多的恢复时间（2.9比2.7; p = 0.504），但他们比接受了3次5例胆囊切除术的组更早恢复工作（5.1比5.9; p = 0.065）。 -mm端口，尽管组之间没有显着差异。有两个3毫米端口的组的手术时间从18.5分钟增加到20.9分钟（p = 0.054）。与对照组相比，当前组中有五名患者（3.1％）需要扩大端口以完成手术。并发症发生率为0.6％，前一组并发症为2.0％。结论：本研究没有证明当肋下和剑突下位置的端口尺寸减小时，术后疼痛的减轻或恢复的持续改善。但是，这确实表明，可以安全地缩小端口的大小，而不会影响外科医生进行胆囊切除术的能力。减小端口尺寸可能是外科医生武器库中的一种工具，可用于优化美容效果。

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