caa a22 4500 475780752 CHVBK 20180406123643.0 cr unu---uuuuu 170329e20000401xx s 000 0 eng 10.1007/s004640020063 doi (NATIONALLICENCE)springer-10.1007/s004640020063 Prospective randomized blinded trial of pulmonary function, pain, and cosmetic results after laparoscopic vs microlaparoscopic cholecystectomy [Elektronische Daten] [W. Schwenk, J. Neudecker, J. Mall, B. Böhm, J. M. Müller] Background: The size of laparoscopic instruments has been reduced for use in abdominal video endoscopic surgery. However, it has yet to be proven that microlaparoscopic surgery will actually result in clinically relevant benefits for patients. Methods: Fifty patients were randomized in a blinded fashion to receive either elective laparoscopic (MINI), (n= 25) or microlaparoscopic (MICRO) (n= 25) cholecystectomy. Pulmonary function (FVC, FEV 1), analgesic consumption during patient-controlled analgesia (PCA), pain perception by visual analogue score (VAS), and the cosmetic result (by the patient's self-assessment) were evaluated postoperatively as clinically relevant end points. Results: Age, sex, body mass index (BMI), preoperative pulmonary function, pain perception, and operative time were similar for the two groups. At 8:00 PM on the day of surgery, FVC (MINI: 1.96 L [range, 1.48-2.48]; MICRO: 2.13 L) [(range, 1.61.-2.50)] and FEV 1 (MINI: 1.17 L/sec) [range, 0.87-1.48]; MICRO: 1.34 L/sec [range, 1.05.-2.14] were also similar (each p= 0.5). From surgery to the 3rd postoperative day, cumulative PCA morphine doses were comparable (MINI: 0.15 mg/kg bw [range, 0.09-0.23]; MICRO: 0.21 mg/kg bw [range, 0.10-0.42]; p= 0.4), but overall VAS scores for pain while coughing were higher in the laparoscopic group (406 [range, 358-514]) than in the microlaparoscopic group (365 [range, 215-427]; p= 0.02). The cosmetic result was judged to be slightly superior by the microlaparoscopic patients (10 [range, 9-10]), as compared to those in the laparoscopic (9 [range, 8-10]) group (p= 0.04). Conclusion: Because microlaparoscopic cholecystectomy has some minor advantages over laparoscopic surgery, it should be considered for use in selected patients. Springer-Verlag New York Inc., 2000 Key words: Cholecystectomy — Gallbladder — Laparoscopic cholecystectomy — Microlaparoscopy — Mini-instruments nationallicence Schwenk W. Department of General, Visceral, Vascular and Thoracic Surgery, Charité Medical School, Campus Mitte, Humboldt University of Berlin, Schumannstr. 20/21 D-10117 Berlin, Germany, DE aut Neudecker J. Department of General, Visceral, Vascular and Thoracic Surgery, Charité Medical School, Campus Mitte, Humboldt University of Berlin, Schumannstr. 20/21 D-10117 Berlin, Germany, DE aut Mall J. Department of General, Visceral, Vascular and Thoracic Surgery, Charité Medical School, Campus Mitte, Humboldt University of Berlin, Schumannstr. 20/21 D-10117 Berlin, Germany, DE aut Böhm B. Department of General, Visceral, Vascular and Thoracic Surgery, Charité Medical School, Campus Mitte, Humboldt University of Berlin, Schumannstr. 20/21 D-10117 Berlin, Germany, DE aut Müller J. M. Department of General, Visceral, Vascular and Thoracic Surgery, Charité Medical School, Campus Mitte, Humboldt University of Berlin, Schumannstr. 20/21 D-10117 Berlin, Germany, DE aut Surgical Endoscopy Springer-Verlag 14/4(2000-04-01), 345-348 0930-2794 14:4<345 2000 14 464 https://doi.org/10.1007/s004640020063 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640020063 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schwenk W. Department of General, Visceral, Vascular and Thoracic Surgery, Charité Medical School, Campus Mitte, Humboldt University of Berlin, Schumannstr. 20/21 D-10117 Berlin, Germany, DE aut NATIONALLICENCE 700 1- Neudecker J. Department of General, Visceral, Vascular and Thoracic Surgery, Charité Medical School, Campus Mitte, Humboldt University of Berlin, Schumannstr. 20/21 D-10117 Berlin, Germany, DE aut NATIONALLICENCE 700 1- Mall J. Department of General, Visceral, Vascular and Thoracic Surgery, Charité Medical School, Campus Mitte, Humboldt University of Berlin, Schumannstr. 20/21 D-10117 Berlin, Germany, DE aut NATIONALLICENCE 700 1- Böhm B. Department of General, Visceral, Vascular and Thoracic Surgery, Charité Medical School, Campus Mitte, Humboldt University of Berlin, Schumannstr. 20/21 D-10117 Berlin, Germany, DE aut NATIONALLICENCE 700 1- Müller J. M. Department of General, Visceral, Vascular and Thoracic Surgery, Charité Medical School, Campus Mitte, Humboldt University of Berlin, Schumannstr. 20/21 D-10117 Berlin, Germany, DE aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/4(2000-04-01), 345-348 0930-2794 14:4<345 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer