Randomized controlled trial of single incision versus conventional multiport laparoscopic cholecystectomy with long-term
- PDF / 532,837 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 33 Downloads / 205 Views
CONTROLLED CLINICAL TRIALS
Randomized controlled trial of single incision versus conventional multiport laparoscopic cholecystectomy with long-term follow-up Denis Klein 1 & Atakan Görkem Barutcu 1 & Dino Kröll 1 & Maik Kilian 1,2 & Johann Pratschke 1 & Roland Raakow 3 & Jonas Raakow 1 Received: 2 April 2020 / Accepted: 12 June 2020 # The Author(s) 2020
Abstract Background Within the last years, single-incision laparoscopic cholecystectomy (SLC) emerged as an alternative to multiport laparoscopic cholecystectomy (MLC). SLC has advantages in cosmetic results, and postoperative pain seems lower. Overall complications are comparable between SLC and MLC. However, long-term results of randomized trials are lacking, notably to answer questions about incisional hernia rates, long-term cosmetic impact and chronic pain. Methods A randomized trial of SLC versus MLC with a total of 193 patients between December 2009 and June 2011 was performed. The primary endpoint was postoperative pain on the first day after surgery. Secondary endpoints were conversion rate, operative time, intraoperative and postoperative morbidity, technical feasibility and hospital stay. A long-term follow-up after surgery was added. Results Ninety-eight patients (50.8%) underwent SLC, and 95 patients (49.2%) had MLC. Pain on the first postoperative day showed no difference between the operative procedures (SLC vs. MLC, 3.4 ± 1.8 vs. 3.7 ± 1.9, respectively; p = 0.317). No significant differences were observed in operating time or the overall rate of postoperative complications (4.1% vs. 3.2%; p = 0.731). SLC exhibited better cosmetic results in the short term. In the long term, after a mean of 70.4 months, there were no differences in incisional hernia rate, cosmetic results or pain at the incision between the two groups. Conclusions Taking into account a follow-up rate of 68%, the early postoperative advantages of SLC in relation to cosmetic appearance and pain did not persist in the long term. In the present trial, there was no difference in incisional hernia rates between SLC and MLC, but the sample size is too small for a final conclusion regarding hernia rates. Trial registration German Registry of Clinical Trials DRKS00012447 Keywords Laparoscopic surgery . Single-incision . Single-port . Cholecystectomy . Multiport
Introduction Since the first laparoscopic cholecystectomy was performed by Mühe et al. in 1985, significant progress in the practice of
* Jonas Raakow [email protected] 1
Department of Surgery, Charité Campus Mitte, Campus Virchow Klinikum, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
2
Department of General and Visceral Surgery, Evangelische Elisabeth Klinik, Lützowstraße 26, 10785 Berlin, Germany
3
Department of General, Visceral and Vascular Surgery, Vivantes Klinikum Am Urban, Dieffenbachstrasse 1, 10967 Berlin, Germany
minimal invasive gallbladder surgery revolutionized the su
Data Loading...
