内结扎法腹腔镜儿童脾切除术的临床体会

目的:探讨內结扎法腹腔镜儿童脾切除术的可行性及临床效果.方法:回顾分析为7例患儿行内结扎法腹腔镜脾切除术的临床资料.镜下先游离显露脾动脉,分别用丝线结扎、切断,再逐一游离显露脾静脉,用丝线结扎、切断.丝线结扎代替Endo-GIA或Hem-o-lok等器械结扎脾门血管.并与同期施行的5例內镜切割闭合钉结扎脾门血管法进行对...

Laparoscopic splenectomy with endo-ligation for children

Objective: To explore the feasibility and clinical therapeutic effects of laparoscopic splenectomy with endo-ligation for children. Methods:The clinical data of 7 children who underwent laparoscopic splenectomy with endo-ligation were analyzed retrospectively.The operation was started with laparoscopic dissection of the splenic artery,followed by ligation using silk threads and transection.Splenic vein was treated in the same way as the splenic artery.Silk ligature of spleen hilum during laparoscopic splenectomy substituted the Endo-GIA or Hem-o-lok,and were compared with 5 patients whose splenic hilum were transected with an Endo-GIA vascular stapler during the same period. Results:All of the seven cases were operated successfully,and no conversions from laparoscopy to open surgery were necessary.The intraoperative blood loss was 10-25 ml(mean,15 ml).The laparoscopic splenectomy time was 120-180 min(mean,150 min).The time used for the spleen removal was from 40 to 60 min.There was no blood transfusion and no serious complications,such as intra-abdominal infection and obvious postoperative bleeding.The operation time of endo-ligation group was a little longer than that of Endo-GIA vascular stapler group. Conclusions:Laparoscopic splenectomy with endo-ligation of the splenic hilum is reliable,which has the same clinical effect as the stapler ligature,but more practical and economical.