CAJ | 학술논문

目的：探讨经脐单孔腹腔镜（LESS）在胆囊切除术中可行性和安全性。方法对照分析经脐单孔腹腔镜与传统腹腔镜（LC）在胆囊手术中的疗效，其中LESS组24例，LC组24例。观察两组手术时间、出血量、中转开腹率、术后体温、并发症、肠道恢复时间（术后排气）、术后住院时间、疼痛指数、美容效果等。术后第2天早晨700采血检测白细胞（WBC）、血清皮质醇（Cortisol，Cor）、免疫球蛋白A（IgA）和补体（C3）。结果两组手术均成功，无1例中转开腹，术后无并发症发生。LESS组手术时间（110．2±29.3）min，较LC组的（77．8±31．2）min长（t＝5．07，P＜0．05）；LESS组术后排气时间（35．3±4．2）h、术后住院时间（4．5±0．7）d，均短于LC组的（46．6±19．2）h、（5．2±0．7）d（t＝3．29、3．23，均P＜0．05）。LESS组美容评分（3．5±0．5）分，较LC组的（2．1±0．5）分高（t＝9．70，P＜0．05）。LESS组Cor（144．5±28．5）μg／L、C3（30．4±1．8）g／L，较 LC组的（160．3±11．8）μg／L、（42．40±2．00）g／L均明显降低（t＝2．51、21.69，均P＜0．05）。结论 LESS在胆囊切除术中安全可行，与LC相比，LESS法手术时间长，但是术后创伤小，术后恢复快，美容效果明显。
목적：탐토경제단공복강경（LESS）재담낭절제술중가행성화안전성。방법대조분석경제단공복강경여전통복강경（LC）재담낭수술중적료효，기중LESS조24례，LC조24례。관찰량조수술시간、출혈량、중전개복솔、술후체온、병발증、장도회복시간（술후배기）、술후주원시간、동통지수、미용효과등。술후제2천조신700채혈검측백세포（WBC）、혈청피질순（Cortisol，Cor）、면역구단백A（IgA）화보체（C3）。결과량조수술균성공，무1례중전개복，술후무병발증발생。LESS조수술시간（110．2±29.3）min，교LC조적（77．8±31．2）min장（t＝5．07，P＜0．05）；LESS조술후배기시간（35．3±4．2）h、술후주원시간（4．5±0．7）d，균단우LC조적（46．6±19．2）h、（5．2±0．7）d（t＝3．29、3．23，균P＜0．05）。LESS조미용평분（3．5±0．5）분，교LC조적（2．1±0．5）분고（t＝9．70，P＜0．05）。LESS조Cor（144．5±28．5）μg／L、C3（30．4±1．8）g／L，교 LC조적（160．3±11．8）μg／L、（42．40±2．00）g／L균명현강저（t＝2．51、21.69，균P＜0．05）。결론 LESS재담낭절제술중안전가행，여LC상비，LESS법수술시간장，단시술후창상소，술후회복쾌，미용효과명현。
Objective To discuss the safety and effectiveness of laparoendoscopic single -site surgery (LESS)in cholecystectomy.Methods LESS and conventional laparoscopic(LC)effect were compared and analyzed in cholecystectomy.48 cases were divided into the two groups,24 cases(group LESS)were cheated by laparoendo-scopic single-site surgery;24 cases(group LC)were cheated by laparoscopic cholecystectomy.Contrasted in their operation time,intraoperative amount of bleeding,intraoperative laparotomy rate,body temperature after operation, complications,intestinal recovery time (postoperative exhaust),hospitalization time after operation,postoperative pain index,cosmetic effect,white blood cell (WBC),serum cortisol (Cortisol,Cor),immunoglobulin A (IgA)and comple-ment (C3 ).Results All cases were successful,no cases converted to laparotomy,no postoperative complications.The operation time of group LESS and group LC were (110.2 ±29.3)min and (77.8 ±31.2)min,respectively,the differ-ence was ststictically significant (t=5.07,P<0.05).The intestinal recovery time and hospitalization time after oper-ation in group LESS were less than that in gruoup LC (P<0.05 ).The cosmetic effect in group LESS (3.5 ± 0.5)was higher than that in group LC(2.1 ±0.5)(P<0.05).Cor and C3 in group LESS were higher than those in group LC(P<0.05 ).Conclusion Laparoendoscopic single -site surgery in cholecystectomy is safe and feasible, compared with traditional laparoscopic operation,operation time in LESS is long,but arapid postoperative recovery, beauty effect is obvious.