- 作者：Daniel J. Ostlie ; ostlie@surgery.wisc.edu ; Obinna O. Adibe David Juang ; Corey W. Iqbal ; Susan W. Sharp ; Charles L. Snyder ; Walter S. Andrews ; Ronald J. Sharp ; George W. Holcomb III III ; Shawn D. St. Peter
- 关键词：Single incision ; Cholecystectomy ; Laparoscopy ; Randomized trial
- 刊名：Journal of Pediatric Surgery
- 出版年：2013
- 出版时间：January, 2013
- 年：2013
- 卷：48
- 期：1
- 页码：209-214
- 全文大小：201 K
Background
Laparoscopy through a single umbilical incision is an emerging technique supported by case series, but prospective comparative data are lacking. Therefore, we conducted a prospective, randomized trial comparing single site umbilical laparoscopic cholecystectomy to 4-port laparoscopic cholecystectomy.Methods
After IRB approval, patients were randomized to laparoscopic cholecystectomy via a single umbilical incision or standard 4-port access. The primary outcome variable was operative time. Utilizing a power of 0.8 and an alpha of 0.05, 30 patients were calculated for each arm. Patients with complicated disease or weight over 100 kg were excluded. Post-operative management was controlled. Surgeons subjectively scored degree of technical difficulty from 1 = easy to 5 = difficult.
Results
From 8/2009 through 7/2011, 60 patients were enrolled. There were no differences in patient characteristics. Operative time and degree of difficulty were greater with the single site approach. There were more doses of analgesics used and greater hospital charges in the single site group that trended toward significance.
Conclusion
Single site laparoscopic cholecystectomy produces longer operative times with a greater degree of difficulty as assessed by the surgeon. There was a trend toward more doses of post-operative analgesics and greater hospital charges with the single site approach.