CAJ | 학술논문

目的：探讨利用手术腹腔镜（OL）和单人操作技术优化经脐腹腔镜手术（U-LESS）的可行性。方法回顾性分析2013年6月－2014年6月86例利用 OL 单人操作技术的 U-LESS 阑尾手术患儿，对比同期32例采用普通腹腔镜（TL）的 U-LESS 阑尾手术患儿，比较术中、术后的表现情况。结果OL 组手术时间（45．6±13．53）min、手术方式中转2例（2．3％），较 TL 组（64．9±14．37）min、手术中转6例（18．8％）相比，差异有统计学意义（P ＜0．05），而 OL 组术中出血（2．8±1．46）ml、住院时间（6．8±1．2）d、戳孔感染2例，与 TL 组的（3．0±1．52）ml、（6．9±1．3）d、1例相比，差异无明显意义（P ＞0．05）。结论通过器械和人员的集约化，可以有效缓解传统 U-LESS 器械人员拥挤的缺点，操作灵活性提高，有利于增加 U-LESS 在阑尾急症手术的应用率。
목적：탐토이용수술복강경（OL）화단인조작기술우화경제복강경수술（U-LESS）적가행성。방법회고성분석2013년6월－2014년6월86례이용 OL 단인조작기술적 U-LESS 란미수술환인，대비동기32례채용보통복강경（TL）적 U-LESS 란미수술환인，비교술중、술후적표현정황。결과OL 조수술시간（45．6±13．53）min、수술방식중전2례（2．3％），교 TL 조（64．9±14．37）min、수술중전6례（18．8％）상비，차이유통계학의의（P ＜0．05），이 OL 조술중출혈（2．8±1．46）ml、주원시간（6．8±1．2）d、착공감염2례，여 TL 조적（3．0±1．52）ml、（6．9±1．3）d、1례상비，차이무명현의의（P ＞0．05）。결론통과기계화인원적집약화，가이유효완해전통 U-LESS 기계인원옹제적결점，조작령활성제고，유리우증가 U-LESS 재란미급증수술적응용솔。
Objective To explore the feasibility of umbilical laparoendoscopic single-site surgery (U-LESS)with operative laparoscope (OL)and solo surgeon.Methods Eighty-six children with acute appendicitis underwent U-LESS with OL from Jun.2013 to Jun.2014,and 32 underwent U-LESS with conventional laparoscope (TL)during the same period.The performance and effect of intra-operative and post-operative were collected and compared.Results There were no significant difference between the OL and TL group in intraoperative blood loss (2.8 ±1.46 ml vs 3.0 ±1.52 ml),postoperative hospital stay (6.8 ±1.2 d vs 6.9 ±1.3 d)and wound infection (2 vs 1 ).But significant difference between the two groups in the mean operating time (45.6 ±13.53 min vs 64.9 ±14.37 min)and operation conversion (2 vs 6).Conclusion The U-LESS with OL and solo surgeon is more feasible for some children with appendicitis than the U-LESS with TL.