title: Quality-of-life measures after single-access versus conventional laparoscopic cholecystectomy: a prospective randomized study.
abstract: BACKGROUND
  This study aimed to compare the short-term outcomes of single-access laparoscopic cholecystectomy (SALC) and conventional laparoscopic cholecystectomy (CLC).
  
  
  METHODS
  In a prospective study, patients with symptomatic cholelithiasis were randomized to SALC or CLC with follow-up at 1 week, 1 and 6 months. The primary end point of this study was to assess the total outcomes of quality of life using the EuroQoL EQ-5D questionnaire. The secondary end points were postoperative pain, analgesia requirement and duration of use, operative time, perioperative complications, estimated blood loss, hospital stay, cosmesis outcome, and number of days required to return to normal activities.
  
  
  RESULTS
  A total of 269 patients were prospectively randomized into two groups (125 in each group after excluding 19 patients for various reasons). The SALC procedure was done safely without intraoperative or major postoperative complications. In four SALC patients, an extra epigastric port was inserted to enhance exposure. There was no open conversion in either group. SALC patients reported better results among four of the EuroQoL EQ-5D dimensions (mobility, self-care, activity, and pain/discomfort) at 1 week after surgery, an improved pain profile at 4, 12, and 24 h, better cosmetic outcome at 1 and 6 months (P ≤ 0.01), shorter duration of need for analgesia (P ≤ 0.02), and earlier return to normal activities (P ≤ 0.026). Operative times, hospital stay, QOL at 1 and 6 months postoperatively, and estimated blood loss were similar for both procedures.
  
  
  CONCLUSIONS
  This study supports other studies that show that SALC is a feasible and promising alternative to traditional laparoscopic cholecystectomy in selected patients with better cosmesis, QOL, and improved postoperative pain results, and it can be performed with the existing laparoscopic instruments.
authors.affiliation: Department of Surgery, Mansoura University Hospital, Gihan El Sadat St., Dakahliya, Mansoura, Egypt. surg_latif@hotmail.com
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Abd Ellatif
authors.forename: Waleed A
authors.initials: WA
authors.lastname: Askar
authors.forename: Ashraf E
authors.initials: AE
authors.lastname: Abbas
authors.forename: Nashat
authors.initials: N
authors.lastname: Noaman
authors.forename: Ahmed
authors.initials: A
authors.lastname: Negm
authors.forename: Gamal
authors.initials: G
authors.lastname: El-Morsy
authors.forename: Ayman
authors.initials: A
authors.lastname: El Nakeeb
authors.forename: Alaa
authors.initials: A
authors.lastname: Magdy
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Amin
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D016896:Treatment Outcome
chemical_list: D000700:Analgesics