RESUMO
Persistent efforts are being made to reduce operative trauma and morbidity and to improve cosmesis following laparoscopic cholecystectomy. The trend is to reduce the number of incisions, and thus single-incision laparoscopic cholecystectomy (SILC) and natural orifice endoscopic surgery (NOTES) are becoming popular. There is a paucity of studies pertaining to cosmetic outcome after SILC and conventional laparoscopic cholecystectomy in rural Indian population. In the present study, the cosmetic outcome of SILC versus conventional laparoscopic cholecystectomy (CLC) in rural Indian population was evaluated. Sixty patients with gallstone disease were randomly assigned to two groups. In group A (n = 30), CLC was performed, while group B (n = 30) was subjected to SILC. The cosmetic outcome was evaluated using a body image questionnaire on the 7th and 30th postoperative days. On the 7th postoperative day, the body image score for SILC was 6.23 ± 0.89 and for CLC, 8.26 ± 1.08 (p < 0.0001), while the cosmetic score for SILC was 19.56 ± 1.07 and for CLC, 15 ± 1.20 (p < 0.0001). On the 30th postoperative day, the body image score for SILC was 5.50 ± 0.68 and for CLC, 8 ± 1.31 (p < 0.0001), while the cosmetic score for SILC was 21.13 ± 0.57 and for CLC, 15.63 ± 1.06 (p < 0.0001), which favored SILC over CLC. The patient perception and acceptance of SILC was better than that of CLC in terms of cosmetic outcome.
RESUMO
INTRODUCTION: Single-incision laparoscopic cholecystectomy (SILC) is considered to be less invasive and have less morbidity than conventional laparoscopic cholecystectomy (CLC). However, there is a relative paucity of data regarding postoperative pain scores in rural Indian populations following SILC. Also, data pertaining to the applicability of SILC in rural Indian population are scant. METHODS: In the present randomized control trial, pain scores after SILC and CLC were evaluated. Sixty patients with gallstone disease were randomly assigned to one of two groups with 30 patients each: the CLC group and the SILC group. Postoperative pain scores were recorded on the visual analog scale at 8 hours, 24 hours and 7 days after surgery. RESULTS: The patients were comparable with respect to age, sex and BMI. Operative time was longer for the SILC group (47.73 ± 5.57 min vs 69.53 ± 8.96 min; P < 0.0001).The pain scores were similar in both groups at 8 hours (3.61 ± 0.41 vs 3.50 ± 0.51; P = 0.36) and 24 hours (3.30 ± 0.59 vs 3.20 ± 0.40; P = 0.44) postoperatively. On day 7, the SILC group had lower pain scores than the CLC group (2.56 ± 0.56 vs 1.16 ± 0.37; P < 0.01). CONCLUSION: There was no distinct advantage to SILC with regard to immediate postoperative pain. Pain was significantly less (P < 0.01) in the SILC group on postoperative day 7.
