完全腹腔镜下脾切除加选择性贲门血管离断术与开腹手术对比研究

目的比较完全腹腔镜脾切除加选择性贲门血管离断术与开腹手术的近期临床效果。方法分析行完全腹腔镜与同期开腹脾切除加门奇静脉断流术各20例患者的临床资料。结果所有手术均获得成功,腹腔镜组的平均手术时间明显长于开腹组(280min vs.220min,P<0.05),而排气时间(48h vs.72h)、术中出血量(420mL vs.610mL)、术后住院时间(11d vs.15d)均明显减少(P<0.05),术后并发症发生率、术后腹腔总引流量无统计学意义(P>0.05)。结论腹腔镜脾切除加选择性贲门血管离断术的近期效果明显优于传统开腹手术,且安全可行,具有微创的优越性。

Comparative Study on the Total Laparoscopic Splenectomy Plus Selective Pericardial Devascularization and Laparotomy

Objective To compare the clinical effect of laparoscopic splenectomy plus selective pericardial devascularization and laparotomy on patients with liver cirrhosis and portal hypertention. Methods The clinical data of 20 cases of laparoscopic splenectomy plus selective pericardial devascularization and 20 cases of laparotomy was analyzed retrospectively. Results The mean operation time was longer in the laparoscopic group than that in the open group (280 min vs. 220 min, P <0.05), the laparoscopic group decreased more significantly in blood loss (420 mL vs. 610 mL), postoperative hospitalization (11 d vs. 15 d, P <0.05) and the mean time of bowel function recovery (48 h vs. 72 h) than the open group, with no significant difference between two groups in total abdominal drainage volume and incidence of complications (P >0.05). Conclusions Clinical effect of patients treated by laparoscopic splenectomy plus selective pericardial devascularizatio is better than that treated by open splenectomy, which is safe, feasible and minimally invasive in clinical practice.