Ankara Mevki Military Hospital, Turkey
Dr. Mehmet Saydam is general surgeon for the Ankara Mevki Military Hospital İn Ankara, Turkey. He received his medical degree from Gulhane Military Medical Academy, Ankara and completed his general surgery expertize and residency at the Gulhane Haydarpasa Training hospital, Istanbul. His board sertified in general surgery and special interest in the microinvasive surgery and laparoscopic surgery. He is a member of such notable medical associations as the Turkish Surgery Institution and Turkish Colorectal Surgery Soceity. Dr. Saydam declares that neither he nor any immediate family member currently has a financial interest, arrangement or affiliation with any organization(s) that may have a direct interest in the subject matter of this continuing medical education presentation.
Introduction: Laparoscopic cholecystectomy (LC), one of the first minimally invasive techniques, was represented in the 1980s. This technique has indisputably many advantages over the open surgery. Recently, another minimally invasive technique which is Single Incision Laparoscopic Cholecystectomy (SILC), developed to reduce the need of multiple ports and has become popular among the surgeons. Various clinical studies have indicated that the SILC has many advantages over the LC such as, reduced postoperative pain, better cosmesis and shorter hospital stay. The aim of this prospective randomized study was to compare outcomes of quality-of-life measures and evaluate the body image and cosmesis between SILC and LC.
Method: This prospective randomized study was conducted between January 2011 and March 2013 at Gulhane Military Medical Academy, Ankara Turkey and Ankara Mevki Military Hospital, Ankara Turkey. All operations were performed by the same and experienced in laparoscopical techniques surgeons. Fifty-two patients were included the study and divided into two groups. Twenty six patients underwent SILC and 26 underwent LC (women/men: 16/10 and 13/13, respectively). Quality-of-life measures were evaluated by the EuroQol EQ-5D questionnaire. Cosmesis and body image were evaluated with the Body Image questionnaire previously used and tested for cesarean section, appendectomy, etc. All statistical analyses and calculations were performed by IBM Statistics 21.0 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) and MS-Excel 2007. A value of p<0.05 was accepted as statistically sinificant.
Result: In the study, 26 individuals underwent SILS and 26 individuals also underwent LC methods. 55.8 % of individuals ( =29) were female, 44.2% (n=23) were men. Mean age was 46.6 ± 14. In both groups, responses of the quality of life scale's "Today is your health?" question and EQ_5D index values did not show statistically significant differences. Answers of the body image survey's 7 and 8th (cosmesis scale (CS) items 6 to 8) questions of individuals were statistically significant.
Conclusion: In this study the only statistically significant value between two groups was the cosmesis scale. Patients who underwent SILC operation had better satisfaction with the appearance of their scar. SILC is feasible and can be done safely and soundly. We propose that further prospective studies of large patient population are needed to assess the advantages of SILS procedure over LC procedure.
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