Quality-of-life measures after single-access versus conventional laparoscopic cholecystectomy: a prospective randomized study
Quality-of-life measures after single-access versus conventional laparoscopic cholecystectomy: a prospective randomized study
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DOI：
10.1007/s00464-012-2625-5
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发表时间：
2013-06-01
影响因子：
3.1
通讯作者：
Amin, Mahmoud
中科院分区：
文献类型：
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作者：
Abd Ellatif, Mohamed E.;Askar, Waleed A.;Amin, Mahmoud
为比较腹腔镜胆囊切除术（SALC）和传统腹腔镜胆囊切除术（CLC）的近期疗效，将有症状的胆石症患者随机分为两组，分别于术后1周、1个月和6个月进行随访。本研究的主要终点是使用EuroQoL EQ-5D问卷评估生活质量的总体结局。次要终点包括术后疼痛、镇痛需求和使用时间、手术时间、围手术期并发症、估计失血量、住院时间、美容效果和恢复正常活动所需的天数。SALC手术安全完成，无术中或术后重大并发症。在4例SALC患者中，插入额外的上腹部端口以增强暴露。两组均无开放性转换。SALC患者报告的四个EuroQoL EQ-5D维度的结果更好术后1周的活动性、自我护理、活动和疼痛/不适，4、12和24小时的疼痛特征改善，1个月和6个月的美容结局更好（P a千分之一货币符号0.01），需要镇痛的持续时间较短（P a千分之一货币符号0.02），并较早恢复正常活动（P a千分之一货币符号0.026）。手术时间，住院时间，术后1个月和6个月的生活质量，估计失血量是相似的两个procedure.This研究支持其他研究表明，SALC是一种可行的和有前途的替代传统的腹腔镜胆囊切除术在选定的患者更好的美容，生活质量，改善术后疼痛的结果，它可以与现有的腹腔镜仪器。
This study aimed to compare the short-term outcomes of single-access laparoscopic cholecystectomy (SALC) and conventional laparoscopic cholecystectomy (CLC).In a prospective study, patients with symptomatic cholelithiasis were randomized to SALC or CLC with follow-up at 1 week, 1 and 6 months. The primary end point of this study was to assess the total outcomes of quality of life using the EuroQoL EQ-5D questionnaire. The secondary end points were postoperative pain, analgesia requirement and duration of use, operative time, perioperative complications, estimated blood loss, hospital stay, cosmesis outcome, and number of days required to return to normal activities.A total of 269 patients were prospectively randomized into two groups (125 in each group after excluding 19 patients for various reasons). The SALC procedure was done safely without intraoperative or major postoperative complications. In four SALC patients, an extra epigastric port was inserted to enhance exposure. There was no open conversion in either group. SALC patients reported better results among four of the EuroQoL EQ-5D dimensions (mobility, self-care, activity, and pain/discomfort) at 1 week after surgery, an improved pain profile at 4, 12, and 24 h, better cosmetic outcome at 1 and 6 months (P a parts per thousand currency sign 0.01), shorter duration of need for analgesia (P a parts per thousand currency sign 0.02), and earlier return to normal activities (P a parts per thousand currency sign 0.026). Operative times, hospital stay, QOL at 1 and 6 months postoperatively, and estimated blood loss were similar for both procedures.This study supports other studies that show that SALC is a feasible and promising alternative to traditional laparoscopic cholecystectomy in selected patients with better cosmesis, QOL, and improved postoperative pain results, and it can be performed with the existing laparoscopic instruments.