CAJ | 학술논문

目的比较经脐切口单孔腹腔镜(NOTES)和标准腹腔镜治疗肾囊肿的安全性及可行性.方法收集自2010年5月至2011年8月经脐切口单孔3通道(Triport)腹腔镜治疗8例肾囊肿(A组),应用标准腹腔镜治疗肾囊肿14例(B组).记录患者年龄、囊肿大小、手术时间、估计术中出血量、术中并发症、留置引流管时间、术后疼痛指数(VAPS)、术后住院时间等临床资料,并对结果进行分析.结果 A组、B组患者囊肿的平均直径分别是:(6.6±2.4)、(7.0±2.5) cm,两组患者均无转为开放手术完成的病例,NOTES组亦无转为标准腹腔镜的病例.A组、B组平均手术操作时间分别为49、35 min,估计术中出血量分别为12、10 ml.患者术后留置引流时间分别各为1d,术后第1天VAPS分别为0、1分,术后住院时间分别为4、5d.两组手术无术中严重并发症,术后无继发性出血和切口感染病例.术者和患者均认为经脐切口手术瘢痕明显较标准腹腔镜3个切口美观.结论 NOTES治疗肾囊肿的安全性和可行性和标准腹腔镜相当,比标准腹腔镜更加符合微创美观的现代手术要求.
목적 비교경제절구단공복강경(NOTES)화표준복강경치료신낭종적안전성급가행성.방법 수집자2010년5월지2011년8월경제절구단공3통도(Triport)복강경치료8례신낭종(A조),응용표준복강경치료신낭종14례(B조).기록환자년령、낭종대소、수술시간、고계술중출혈량、술중병발증、류치인류관시간、술후동통지수(VAPS)、술후주원시간등림상자료,병대결과진행분석.결과 A조、B조환자낭종적평균직경분별시:(6.6±2.4)、(7.0±2.5) cm,량조환자균무전위개방수술완성적병례,NOTES조역무전위표준복강경적병례.A조、B조평균수술조작시간분별위49、35 min,고계술중출혈량분별위12、10 ml.환자술후류치인류시간분별각위1d,술후제1천VAPS분별위0、1분,술후주원시간분별위4、5d.량조수술무술중엄중병발증,술후무계발성출혈화절구감염병례.술자화환자균인위경제절구수술반흔명현교표준복강경3개절구미관.결론 NOTES치료신낭종적안전성화가행성화표준복강경상당,비표준복강경경가부합미창미관적현대수술요구.
Objective To compare the safety and feasibility of natural orifice transumbilical endoscopic surgery (NOTES) versus conventional laparoscopic surgery in renal cyst deroofing.Methods From May 2010 to August 2011,8 cases of renal cysts underwent cyst deroofing by the technique of NOTES (Triport) (group A) and 14 cases by conventional laparoscopic surgery (Group B) respectively.The data of patient age,cyst size,operative duration,estimated blood loss,intra-operative complications,drainage duration,post-operative pain score (VAPS) and post-operative hospital stay were recorded and analyzed.Results The average cyst sizes of groups A and B were 6.6 ± 2.4 and 7.0 ± 2.5 cm.There was no conversion to open surgery in neither groups and no conversion to standard laparoscopic surgery in group A.The operative duration,estimated blood volume,VAPS and post-operative hospital stay of both groups were 49 vs 35 min,12 vs 10 ml,0 vs 1 and 4 vs 5 days respectively.The drainage duration was 1 day for both groups.No severe complication,secondary hemorrhage or wound infection occurred in neither groups.As judged by both surgeons and patients,the post-operative cosmetic appearances of group A were better than those of group B.Conclusion The cyst deroofing by NOTES is a safe and feasible option for the treatment of renal cysts. As compared with conventional laparoscopic surgery,NOTES may achieve better cosmetic effects with smaller wounds.