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Titolo:
Three-port microlaparoscopic cholecystectomy in 159 patients
Autore:
Leggett, PL; Bissell, CD; Churchman-Winn, R; Ahn, C;
Indirizzi:
Univ Texas, Houston Hlth Sci Ctr, Houston NW Med Ctr, Houston, TX 77090 USA Univ Texas Houston TX USA 77090 Houston NW Med Ctr, Houston, TX 77090 USA Univ Texas, Houston Med Sch, Houston, TX USA Univ Texas Houston TX USAUniv Texas, Houston Med Sch, Houston, TX USA
Titolo Testata:
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES
fascicolo: 3, volume: 15, anno: 2001,
pagine: 293 - 296
SICI:
0930-2794(200103)15:3<293:TMCI1P>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
LAPAROSCOPIC CHOLECYSTECTOMY; 2-PORT TECHNIQUE; GALLBLADDER;
Keywords:
laparoscopic cholecystectomy; laparoscopic surgery; laparoscopy; microlaparoscopic cholecystectomy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
16
Recensione:
Indirizzi per estratti:
Indirizzo: Leggett, PL Univ Texas, Houston Hlth Sci Ctr, Houston NW Med Ctr, 80 Peakwood,Suite 8B, Houston, TX 77090 USA Univ Texas 80 Peakwood,Suite 8B HoustonTX USA 77090 77090 USA
Citazione:
P.L. Leggett et al., "Three-port microlaparoscopic cholecystectomy in 159 patients", SURG ENDOSC, 15(3), 2001, pp. 293-296

Abstract

Background: Laparoscopic cholecystectomy has undergone many refinements including reductions in port size and number. This study attempts to determine whether further reduction in port size from that previously reported by us can reduce postoperative pain without compromising the efficacy of the surgery. Methods: In this study, 159 patients underwent laparoscopic cholecystectomy with three ports: one 5-mm umbilical port, one 3-mm subxiphoid port, and one 3-mm port in the right subcostal position. Data were collected prospectively for each patient on the duration of analgesic use, quantity of analgesic tablets consumed, postoperative pain, most painful incision, and days of recovery required before return to activity and work. These measures werecompared with those collected from a group of 100 patients who had undergone laparoscopic cholecystectomy with three 5-mm ports in a previous study. Results: Patients in the current study group required analgesics for a longer duration (4 vs 2.9 days; p = 0.001), used more analgesic tablets (10.7 vs 8.1; p = 0.007), and re ported greater postoperative discomfort (5 vs 4.1; p = 0.016) as compared with all in the 5-mm port group. The 3-mm port group needed more days for recovery before leaving the house (2.9 vs 2.7; p =0.504), but they returned to work earlier (5.1 vs 5.9; p = 0.065) than thegroup that had undergone cholecystectomy with three 5-mm ports, although there was not a significant difference between the groups. Operative time increased from 18.5 to 20.9 min (p = 0.054) in the group with two 3-mm ports. Five patients (3.1%) in the current group required enlargement of a port to complete the procedure, as compared with none in the comparison group. There was one complication (0.6%), as compared with two complications (2.0%) in the previous group. Conclusions: This study did not demonstrate a reduction in postoperative pain or a consistent improvement in recovery when the port size was reduced at the subcostal and subxiphoid positions. It did, however, show that portscould safely be reduced in size without a negative impact on the surgeon'sability to perform a cholecystectomy. Reducing port size can be a tool in the surgeon's armamentarium for use in the attempt to optimize cosmetic results.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 10:10:43