摘要
目的探索一种改进型腹腔镜微创手术方式,以减少手术创伤、降低手术难度、增加手术适应证。方法回顾性分析2021年7月至2023年8月间在联勤保障部队第九〇一医院普外科进行双镜联合经胆总管探查取石53例病人的临床资料,根据手术方式的不同,将采用单孔加一孔双镜联合经胆总管探查取石术的病人纳入观察组(29例),将采用单孔双镜联合胆道探查取石术的病人纳入对照组(24例),对比两组围手术期情况。正态分布的计量资料采用x±s表示,组间比较采用独立样本t检验,偏态分布的定量资料采用M(Q_(1),Q_(3))表示,采用Mann-Whitney U检验。结果两组病人基线资料差异均无统计学意义(均P>0.05)。观察组较对照组手术时间缩短[130.0(120.0,152.5)min比150.0(130.0,195.0)min,Z=-2.789,P=0.005],术中出血量减少[10.0(10.0,20.0)mL比20.0(16.3,37.5)mL,Z=-2.918,P=0.004];观察组与对照组的术后排气时间[(17.9±4.0)h比(19.5±3.6)h]、术后住院时间[(7.0±1.8)d比(7.5±2.8)d]、住院费用[(19826.2±4073.8)元比(21668.3±5191.2)元]比较,差异均无统计学意义(均P>0.05)。结论单孔加一孔双镜联合经胆总管探查取石术可行、安全,使微创手术学习曲线缩短,术中用时减少,应用指征更广泛。
Objective To explore an improved laparoscopic mini-invasive surgery to minimize surgical trauma,lower surgical difficulty and expand clinical indications.Methods From July 2021 to August 2023,the relevant clinical data were retrospectively reviewed for 53 patients undergoing laparoendoscopy with transbiliary exploration for lithotomy.According to different surgical approaches,they were assigned into two groups of single-port plus one-port surgery(n=29)and single-port laparoscopy(n=24).Results No significant differences existed in baseline profiles(P>0.05).Significant inter-group difference existed in operative duration[130.0(120.0,152.5)vs.150.0(130.0,195.0)min]and intraoperative volume of blood loss[10.0(10.0,20.0)vs.20.0(16.3,37.5)mL](P<0.05).No significant inter-group differences existed in postoperative exhaust time[(17.9±4.0)vs.(19.5±3.6)h],postoperative hospitalization stay[(7.0±1.8)vs.(7.5±2.8)day]or hospitalization expense[(19826.2±4073.8)vs.(21668.3±5191.2)yuan](all P>0.05).Conclusion It is both feasible and safe to use single hole plus one hole double mirror plus choledochal exploration and lithotomy.It may flatten the learning curve of mini-invasive surgery,shorten operative duration and expand clinical indications.
作者
刘鹏
牛小行
黄朝君
孙爱学
魏晓明
Liu Peng;Niu Xiaohang;Huang Chaojun;Sun Aixue;Wei Xiaoming(Department of General Surgery,No.901 Hospital of PLA,Anhui Hefei 230031,China)
出处
《腹部外科》
2024年第3期207-211,共5页
Journal of Abdominal Surgery
基金
联勤保障部队第九〇一医院院管课题(2021YGYB03)。
关键词
单孔加一孔
双镜联合
胆总管结石
微创
Single-incision plus one-port
Laparoendoscopy
Choledocholithiasis
Miniinvasiveness
作者简介
刘鹏,副主任医师,主要从事肝胆疾病方向的综合治疗,Emial:42076037@qq.com;通信作者:魏晓明,Emial:wxm9810@163.com。
