Clinical Comparative Study Of Modified Transumbilical Sing Le-port Laparoscopic Cholecystectomy And Conventional Lap Aroscopic Cholecystectomy

Objective To explore the safety,superiority and technical points of modified tra nsumbilical single-port laparoscopic cholecystectomy(TSPLC)in clinical applic ation.Methods Retrospective case-control study were used to collect the clinical data of 100 patients(single-port group LC 50 cases,three-port group LC 50 cases)wit h laparoscopic cholecystectomy(LC)in our hospital from January 2014 to october2016 to observe and compare with perioperative related clinical indicators(oper ating time,intraoperative blood loss,pain scores,rate of postoperative analgesic dr ugs,time of hospitalization,incision satisfaction,wound complications and single-h ole group operation time),at the same time,to detect and compare the related l aboratory indicators: trauma indicators[(C reaction protein,CRP),(white blood cell count,WBC)],immunological indicators[(immune globulin M,Ig M),CD4+(cluster of differentiation 4,CD4+)] by extracting peripheral venous blood.Preoperative gen eral condition observationResults All the operations of two group patients were successfully completed,n ot placed drainage tube.There was no statistical significance in Preoperative gener al condition observation(P>0.05);operating time of single-port group was longer than three-port group(P<0.01);Pain scores at 6h,rate of postoperative analgesi c drugs were significantly lower than that of three-port group(P<0.05;P<0.01);Wound complications was significantly higher than that of three-port group(P<0.01);There were no significant differences in intraoperative blood loss,pain scoresat 24 h,length of hospital stay between the single-hole group and the three-hole group.In the first 10 patients,the mean operative time of single-hole group wa s(89.40 ± 8.28)min,and the average operative time was(62.90 ± 9.76)min,so the difference was statistically significant(p<0.01).Linear regression analysis sh owed that the operation time of single-hole group was shortened(r=-0.426,p<0.01),but the operation timewas longer than that of the traditional three-hole group(46.88±7.32)min,the difference was statistically Significance(p<0.01);There were no significant differencesin CRP,WBC,Ig M,CD3 + in 1d before surgery,1d aft er surgery,postoperative3 d and postoperative complication such as incision hernia between the single-hole group and the three-hole group even from 2 to3 months following up(p>0.05).Conclusion Compared with traditional LC,TSPLC has obvious advantages in p ostoperative recovery,incision pain,cosmetic effect and so on,at the same time,the surgical equipment requirements are not high,the traditional equipment will be able to complete,the operation time is gradually shortened with the increase of the operation volume and the accumulation of experience.In addition,its the impact of the wound and immune function of the body is similar to the traditio nal LC,indicating that modified transumbilical single-port laparoscopic cholecyste ctomy is safe and feasible,and does not increase the risk of surgery,for the pri mary hospital has been carried out LC,it has a certain value to promote.But d ue to surgical technical requirement being higher,the operation being more diffic ult and the learning curve being relatively more longer,it needs a surgeon with a certain experience of laparoscopic surgery to complete.