A randomized controlled trial for evaluation of lower abdominal laparoscopic cholecystectomy.

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A randomized controlled trial for evaluation of lower abdominal laparoscopic cholecystectomy.

Minim Invasive Ther Allied Technol. 2017 May 24;:1-8

Authors: Xu L, Tan H, Liu L, Si S, Sun Y, Huang J, Atyah M, Yang Z

Abstract
BACKGROUND: To improve minimally invasive outcomes, we designed a new procedure, lower abdominal laparoscopic cholecystectomy (LALC). This study was conducted to evaluate the effects of LALC versus classical (CLC) and single-incision (SILC) laparoscopic cholecystectomy on reducing systemic acute inflammatory response, improving cosmesis, and postoperative pain relief.
MATERIAL AND METHODS: Beginning from July 2014, 105 patients meeting the inclusion criteria were randomly assigned to three groups: LALC, CLC, and SILC. The primary endpoint was the determination of systemic inflammatory response to the surgery. Other outcome measures included cosmesis, postoperative pain, and perioperative indices.
RESULTS: Each of the three groups consisted of 35 patients. The duration of the operation was significantly longer in the SILC group (p= .005). The rates of adverse events were similar. Changes in interleukin-6 (p =  .001) and tumor-necrosis factor-α (p =  .016) measured before and after surgery differed significantly; patients who underwent LALC had the smallest change in inflammatory response. Cosmesis scores at one (p =  .002) and 12 (p =  .004) weeks after surgery favored LALC and SILC. Significant differences in pain scores at four (p =  .011) and 12 h (p =  .024) postoperatively were also observed.
CONCLUSIONS: In selected patients, LALC shows more advantages in terms of lower systemic inflammatory response, improved cosmesis, and a favorable postoperative pain profile when compared with CLC and SILC.

PMID: 28537508 [PubMed - as supplied by publisher]

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