Comparative Analysis Of The Clinical Efficacy Of Transumbilical Single-port Laparoscopy And Traditional Multi-port Laparoscopy In The Treatment Of Gastroduodenal Ulcer Perforation

Objective: to investigate the clinical efficacy and safety of transumbilical single-port laparoscopy in the treatment of gastroduodenal ulcer perforation.Methods: a total of 50 patients with gastroduodenal ulcer perforation diagnosed in the fourth affiliated hospital of nanchang university between January 2015 and August 2017,who met the inclusion criteria and were treated by laparoscopic ulcer perforation repair,were randomly divided into the single-hole group and the multi-hole group by prospective study analysis.There were 25 patients in each of the two groups,2 patients in the single-hole group gave up surgery before surgery,3 patients changed the operation mode due to the intraoperative evidence of malignant tumor,and finally 20 patients underwent trans-umbilical single-hole laparoscopic gastroduodenal ulcer perforation repair(single-hole group),and 25 patients underwent traditional multi-hole laparoscopic gastroduodenal ulcer perforation repair(multi-hole group).After statistical analysis,the operative time,intraoperative blood loss,postoperative exhaust time,hospitalization time,incision infection rate,analgesic usage rate and transit rate(increased operating hole)were compared between the two groups.Results: the results of the two groups were compared.The operation time: the operation time of the transumbilical single-hole laparoscopic group(72.6 15.5)min was not significantly different from that of the traditional multi-hole laparoscopic group(68.2 10.4)min(P>0.05).Intraoperative blood loss: there was no significant difference in intraoperative blood loss(11.5 3.6)ml between the umbilical single-hole laparoscopy group and the traditional multi-hole laparoscopy group(12.1 4.2)ml(P > 0.05).In terms of transit rate(increase of operating hole),only 1 case of single hole group increased operating hole(5%);No operating holes were added in the porous group,and no laparotomy was transferred in the two groups.The postoperative exhaust time of the single hole group was 45.9 8.8h,which was significantly superior to that of the porous group(54.4 9.5h)(P<0.05).Postoperative incision infection occurred in 1 case(4%)in the porous group,which was not significantly different from that in the single-porous group(P<0.05),and postoperative analgesic use in the single-porous group was less than that in the porous group(P<0.05),which was statistically significant.The length of hospital stay in the two groups was 7.2 1.4d and 8.5 1.7d,respectively.The single-hole group had more advantages in shortening the length of hospital stay,and no postoperative complications such as gastric fistula and intestinal fistula,bleeding and abdominal infection occurred in all the cases.Conclusion: The most important advantage of single-port laparoscopic repair of peptic ulcer perforation in clinical application compared with traditional laparoscopic surgery lies in its superior cosmetic effect,which is suitable for patients with special requirements for the cosmetic effect of incision.This study single-hole group compared with the traditional porous laparoscopic surgery has a quicker recovery of gastrointestinal function,short hospital stay,postoperative pain,the advantages of the lighter,but due to carry out this study time is short,so the cases data is less,need a greater number of clinical studies and clinical evidence to support data,need more multi-center prospective randomized controlled trial study,can clear single-arch laparoscopic gastroduodenal ulcer perforation in the advantages of using gradually to clinical application.