PURPOSE: In spite of its safety and fesibility, it is not completely certain whether two-port laparoscopic cholecystectomy can be applied for the same indications as four-port cholecystectomy. METHODS: We retrospectively analyzed the prospectively collected data of the patients who had undergone either two-port or four-port laparoscopic cholecystectomy at the Department of Surgery, Daejeon St. Mary's Hospital between March 2007 and August 2009. A total of 341 patients were included. For our two-port cholecystectomy, combining a transumbilical wound retractor with a surgical glove on which there was a 11 mm trocar and two pipes were attached comprised an umbilical common channel, and another port was inserted through the epigastrium. The overall procedure was similar to four-port laparoscopic cholecystectomy. RESULTS: The patients were classified into the four-port group (n=261) and the two-port group (n=80) according to the operative method. All the two-port cholecystectomies were followed by four-port procedures. The operative indications for these two procedures were identical. No significant difference was observed for the mean operation time, the conversion rate, the postoperative hospital stay and the complications between each group. Multivariate analysis revealed that the factors making two-port surgery longer than the 75 percentile of the overall operation time were the development of intraoperative complications (RR 14.3; p=0.005; C.I. 2.255-90.853), a operation for the patients who visited the emergency room (RR 10.4; p=0.012; C.I. 1.684-63.798), open conversion or making additional port(s) (RR 9.9; p=0.032; C.I. 1.219-80.958) and a body-mass index greater than 25 (RR 5.5; p=0.025; C.I. 1.244-24.731). CONCLUSION: This study documents that our two-port laparoscopic cholecystectomy seems to have the potential to replace the conventional four-port laparoscopic cholecystectomy.
Alkanesulfonic Acids ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Emergencies ; Gloves, Surgical ; Humans ; Intraoperative Complications ; Length of Stay ; Multivariate Analysis ; Piperazines ; Prospective Studies ; Retrospective Studies ; Surgical Instruments

PURPOSE: In spite of its safety and fesibility, it is not completely certain whether two-port laparoscopic cholecystectomy can be applied for the same indications as four-port cholecystectomy. METHODS: We retrospectively analyzed the prospectively collected data of the patients who had undergone either two-port or four-port laparoscopic cholecystectomy at the Department of Surgery, Daejeon St. Mary's Hospital between March 2007 and August 2009. A total of 341 patients were included. For our two-port cholecystectomy, combining a transumbilical wound retractor with a surgical glove on which there was a 11 mm trocar and two pipes were attached comprised an umbilical common channel, and another port was inserted through the epigastrium. The overall procedure was similar to four-port laparoscopic cholecystectomy. RESULTS: The patients were classified into the four-port group (n=261) and the two-port group (n=80) according to the operative method. All the two-port cholecystectomies were followed by four-port procedures. The operative indications for these two procedures were identical. No significant difference was observed for the mean operation time, the conversion rate, the postoperative hospital stay and the complications between each group. Multivariate analysis revealed that the factors making two-port surgery longer than the 75 percentile of the overall operation time were the development of intraoperative complications (RR 14.3; p=0.005; C.I. 2.255-90.853), a operation for the patients who visited the emergency room (RR 10.4; p=0.012; C.I. 1.684-63.798), open conversion or making additional port(s) (RR 9.9; p=0.032; C.I. 1.219-80.958) and a body-mass index greater than 25 (RR 5.5; p=0.025; C.I. 1.244-24.731). CONCLUSION: This study documents that our two-port laparoscopic cholecystectomy seems to have the potential to replace the conventional four-port laparoscopic cholecystectomy.
Alkanesulfonic Acids ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Emergencies ; Gloves, Surgical ; Humans ; Intraoperative Complications ; Length of Stay ; Multivariate Analysis ; Piperazines ; Prospective Studies ; Retrospective Studies ; Surgical Instruments

Objective: To investigate the correlation between the prenatal exposure of per-/polyfluoroalkyl substances (PFASs) and the neonatal outcome. Methods: A total of 506 maternal infant cohort samples were collected in Hangzhou, Zhejiang province from 2020 to 2021. The exposure levels of seven PFASs in maternal serum before delivery were detected by solid-phase extraction-ultra performance liquid chromatography tandem mass spectrometry. Multivariable linear regression model was used to analyze the influence of prenatal exposure of PFASs on birth weight, birth length and Apgar score. Results: The maternal age, prenatal body mass index and gestation age were (31.3±4.3) years old, (26.7±3.2) kg/m² and (265.0±28.3) days, respectively. The birth weight, birth length and scores of Apgar-1 and Apgar-5 were (3.1±0.8) kg, (49.3±2.9) cm, (9.88±0.47) points and (9.99±0.13) points, respectively. PFASs were widely distributed in maternal serum, with the highest concentration of (18.453±19.557) ng/ml, (6.756±9.379) ng/ml and (5.057±8.555) ng/ml for perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS) and 6∶2 chlorinated polyfluorinated ether sulfonate (Cl-PFESA), respectively. Maternal age, parity and delivery mode were associated with the exposure level of PFASs (P<0.05). Subgroup analysis showed that PFOS had negative effects on birth weight (β=-0.958), birth length (β=-0.073) and Apgar-5 score (β=-0.288) for neonates in the low birth weight (LBW) group. 6∶2 Cl-PFESA and 8∶2 Cl-PFESA inhibited the birth weight (β=-0.926; β=-0.552) and length (β=-0.074; β=-0.045) of newborn in the LBW group. In addition, 4∶2 fluorotelomer sulfonate (FTS) was associated with increased birth weight (β=0.111) and decreased Apgar-5 score (β=-0.030) in the normal weight group. Conclusion: Prenatal exposure to PFASs is associated with birth weight, birth length and Apgar-5 score. It is necessary to continue to pay attention to the impact of PFASs on fetal growth and development through maternal-fetal transmission.
Pregnancy ; Infant, Newborn ; Female ; Humans ; Adult ; Birth Weight ; Prenatal Exposure Delayed Effects ; Alkanesulfonic Acids/analysis* ; Alkanesulfonates/analysis* ; Fluorocarbons/analysis* ; Ethers/analysis* ; Ethyl Ethers/analysis* ; Environmental Pollutants/analysis* ; Maternal Exposure