Quality of life after single-incision laparoscopic cholecystectomy: A randomized, clinical trial
Quality of life after single-incision laparoscopic cholecystectomy: A randomized, clinical trial
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DOI：
10.1016/j.surg.2018.08.004
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发表时间：
2019-02-01
期刊：
影响因子：
3.8
通讯作者：
Takada, Yasutsugu
中科院分区：
文献类型：
--
作者：
Ito, Eitaro;Takai, Akihiro;Takada, Yasutsugu
背景资料：与更经典的四孔腹腔镜胆囊切除术相比，脐部切口稍大的单切口腹腔镜胆囊切除术是否会导致术后生活质量更差和疼痛更多仍存在争议。本研究的目的是比较单切口和4孔腹腔镜胆囊切除术的生活quality.Methods的角度来看：本研究是一项多中心，平行组，开放标签，随机临床试验。将120例择期行胆囊切除术的患者按1：1随机分为单孔腹腔镜胆囊切除术组和4孔腹腔镜胆囊切除术组，术后连续评估2周。主要结局是生活质量，定义为恢复正常日常活动的时间。还评估了术后疼痛。为了探讨治疗效果的异质性，我们评估了性别，年龄和工作状态的相互作用恢复time.Results：共58例患者在单切口组和53在4端口组（n = 111，47名男性，平均年龄57岁）进行了分析。单切口和四孔腹腔镜胆囊切除术患者恢复日常活动的平均时间分别为10.2天和8.8天（95%置信区间为-0.4至3.2，P= 0.12）。同样，术后疼痛缓解的时间在两组之间没有显著差异。统计学上不显着，但定性的相互作用，注意到，在妇女，全职工作者，和患者年龄小于60岁的亚组，恢复往往是缓慢的单切口腹腔镜胆囊切除术后，结论：术后生活质量没有显着差异单切口腹腔镜胆囊切除术和4孔腹腔镜胆囊切除术。年龄小于60岁的患者、女性和全职工作者在单切口腹腔镜胆囊切除术后恢复较慢。(C)2018作者（S）爱思唯尔公司出版
Background: Controversy continues as to whether single-incision laparoscopic cholecystectomy, with the somewhat larger incision at the umbilicus, may lead to a worse postoperative quality of life and more pain compared with the more classic 4-port laparoscopic cholecystectomy. The aim of this study was to compare single-incision and 4-port laparoscopic cholecystectomy from the perspective of quality of life.Methods: This study was a multicenter, parallel-group, open-label, randomized clinical trial. A total of 120 patients who were scheduled to undergo elective cholecystectomy were randomly assigned 1:1 into the single-incision laparoscopic cholecystectomy or the 4-port laparoscopic cholecystectomy group and then assessed continuously for 2 weeks during the postoperative period. The primary outcome was quality of life, defined as the time to resume normal daily activities. Postoperative pain was also assessed. To explore the heterogeneity of treatment effects, we assessed the interactions of sex, age, and working status on recovery time.Results: A total of 58 patients in the single-incision group and 53 in the 4-port group (n = 111, 47 male, mean age 57 years) were analyzed. The mean time to resume daily activities was 10.2 days and 8.8 days, respectively, for single-incision and 4-port laparoscopic cholecystectomy (95% confidence interval -0.4 to 3.2, P=.12). Similarly, the time to relief from postoperative pain did not differ significantly between the groups. Statistically insignificant but qualitative interactions were noted; in the subgroups of women, full-time workers, and patients younger than 60 years, recovery tended to be slower after single-incision laparoscopic cholecystectomy.Conclusion: Postoperative quality of life did not differ substantially between single-incision laparoscopic cholecystectomy and 4-port laparoscopic cholecystectomy. Patients younger than 60 years, women, and full-time workers tended to have a somewhat slower recovery after single-incision laparoscopic cholecystectomy. (C) 2018 The Author(s). Published by Elsevier Inc.