摘要
目的 通过与常规三孔法腹腔镜胆囊切除术(LC)进行对比,分析改良Trocar入路LC的临床优势.方法 回顾性分析2015年1月至2023年9月于温州医科大学附属第一医院行改良Trocar入路LC(改良组)的202例胆囊良性病变患者的临床资料,其中男性84例,女性118例,年龄(49.58±13.03)岁.纳入同期行常规三孔法LC的606例胆囊良性病变患者作为对照组,其中男性245例,女性361例,年龄(50.99±12.55)岁.比较两组患者的手术时间、中转四孔法率、术后并发症、术后住院时间、术后疼痛评分和术后满意度评分等指标.结果 两组患者均无严重并发症发生.改良组有3例(1.5％,3/202)中转四孔法,对照组有7例(1.2％,7/606)中转四孔法,两组中转四孔法率比较,差异无统计学意义(P＞0.05).改良组与对照组患者的手术时间分别为(40.28±13.51)min和(40.38±18.75)min,差异无统计学意义(P＞0.05).与对照组相比,改良组患者术后数字评分量表评分更低[(2.49±1.23)分比(3.02±1.48)分],术后住院时间更短[(2.87±0.93)d比(3.80±1.31)d],Kiyak评分更高[(4.31±0.66)分比(4.15±0.63)分],差异均具有统计学意义(均P＜0.05).结论 改良Trocar入路LC与常规三孔法LC具有同样的安全性,但改良Trocar入路LC术后住院时间更短、疼痛更轻、疤痕更隐蔽、患者满意度更高.
Abstract
Objective To analyze the clinical advantages of the modified Trocar approach in laparo-scopic cholecystectomy(LC)compared to the conventional three-hole approach.Methods Clinical data of 202 patients undergoing the modified Trocar approach LC(the modified group)at the First Affiliated Hospi-tal of Wenzhou Medical University from January 2015 to September 2023 were retrospectively analyzed,including 84 males and 118 females patients,aged(49.58±13.03)years old.The conventional group enrolled 606 patients,including 245 males and 361 females,aged(50.99±12.55)years old.The opera-tive time,conversion to four-hole approach,postoperative complications,hospital stay,pain score,and satis-faction score were compared between the groups.Results No severe complications occurred in either group.In modified group,three cases(1.5％,3/202)required conversion to four-hole approach,while in conventional group,seven(1.2％,7/606)required conversion,with one case conversed to open surgery(P＞0.05).The operative time in modified and conventional groups were(40.28±13.51)min and(40.38±18.75)min,respectively(P＞0.05).The postoperative pain scores were 2.49±1.23 and 3.02±1.48,respectively(t=5.05,P＜0.001).The average postoperative hospital stays were(2.87±0.93)d and(3.80±1.31)d,respectively(t=11.05,P＜0.001).The postoperative Kiyak satisfaction scores were 4.31±0.66 and 4.15±0.63,respectively(t=2.93,P=0.004).Conclusion The safety of modi-fied Trocar approach is comparable to that of conventional three-hole approach.The modified approach showed a shorter postoperative hospital stay,less pain,better scars,and higher patient satisfaction.
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