2011, Number 1
Needlescopic cholecystectomy with two ports vs Laparoscopic cholecystectmy with three ports. Which is better?
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ABSTRACTObjective: To compare needlescopic cholecystectomy with usual laparoscopic cholecystectomy with three ports. Setting: General Hospital, “Dr. Darío Fernández Fierro”, ISSSTE, Mexico City. Second level health care hospital.
Design: A prospective and randomized in parallel controled clinical assay.
Patients and methods: Patients older than 20 years who needed cholecystectomy due to gallbladder pathology confirmed by ultrasound (US) were included in this study. The study was performed in the period from December 2006 to February 2008; patients were divided randomly in two groups. All patients signed the institutional informed consent form. One group of 50 patients was subjected to needlescopic cholecystectomy and the other to laparoscopic cholecystectomy. We recorded, age, gender, surgical time, transoperative complications, pre-surgical diagnosis, length of post-surgery in-hospital stay, intensity and site of post-surgical pain, and aesthetic perception after surgery.
Statistical analysis: We performed a group analysis and then a comparison study between both techniques, using the SPSS version 15 software. Quantitative variables were analyzed using Student’s t test and qualitative variables were assessed with Chi square.
Results: Variables corresponding to age, gender, pre-operative diagnosis, type of intervention according to surgical need, post-surgical in hospital stay, intensity of post-surgical pain at 6, 12, 18, and 24 h revealed no statistically significant differences.
Only four variables were statistically significant: average surgical time (P = 0.0013), pain perceived at 6 hours after surgery (P = 0.0038), localization of post-surgical pain (P = 0.0005), post-surgical aesthetic perception (P = 0.00004).
Conclusions: Given the results of the statistical analysis, we consider that needlescopic cholecystectomy excels by very little the usual laparoscopic cholecystecomy, because the former is a less invasive procedure, which translates into less post-surgical pain but above all a more accepted and preferred aesthetic result for the patient.
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