完全腹腔镜脾切除贲门周围血管离断术的临床应用及评价

目的 探讨完全腹腔镜脾切除、贲门周围血管离断术的方法、安全性和有效性。方法 回顾分析我院2008年1月至2010年12月进行的43例脾切除、贲门周围血管离断术患者的临床资料。43例中19例行腹腔镜手术，24例行开腹手术。比较两组平均手术时间、术中出血量、术后排气时间、术后发热时间、术后住院天数等情况。结果 腹腔镜组术中出血量、术后排气时间、术后发热时间、术后住院天数均明显优于开腹组。腹腔镜组平均手术时间略长于开腹组。结论 完全腹腔镜脾切除、贲门周围血管离断术，尤其在右斜位下是安全、有效、可行的。

The Evaluation and Clinical Application of Total Laparoscopic Splenectomv Combined and Pericardial Devascularization

Objective To explore the method, safety and efficacy of total laparoscopic splenectomy （LS） and pericardial devascularization. Methods The clinical data of 43 patients with splenectomy combined and pericardial devascularization ：from January 2008 to December 2010 in our hospital （19 for total laparoscopic surgery and 24 for open surgery）was retrospectively analyzed. The mean operative time,intraoperative blood loss,anal exsufflation time,fevered time,the time of postoperative hospitalization were compared between the two groups. Results Compared with open surgery group,the laparoscopic group was less intraoperative blood loss,shorter time of anal exsufflation,fever and postoperative hospitalization. The mean operation time was longer in the laparoscopic group than that in the open group. Conclusion Total laparoscopic splenectomy and pericardial devascularization is safe,effective and feasible,especially in lateral decubitus position.