直线切割缝合器行二级脾蒂离断术在创伤性脾破裂脾切除术中的应用

目的创伤性脾破裂患者行脾切除术时，传统方法脾门的处理采用大块组织结扎，此法术后易发生一些常见并发症，如脾热、胰尾损伤、出血等。我院从2007年10月～2009年2月对部分创伤性脾破裂患者行脾切除时运用直线切割缝合器行二级脾蒂离断术，以探讨其对术后并发症及预后的影响。方法回顾性分析比较了传统组与对照组共112例纳入患者的临床资料，运用统计学方法获得有意义的结果。结果对照组中脾热、胰漏等术后发生率降低；血性引流物持续时间与住院时间缩短。结论直线切割缝合器行二级脾蒂离断术在创伤性脾破裂脾切除中的应用，可降低常见并发症发生率，改良预后，是一种值得推广的术式。

Linear cutter-assisted splenectomy for traumatic spleen rupture

Objective For traumatic spleen ruptures splenectomies were often indicated. When traditional splenectomies were carried out, splenic pedicles were ligated en bloc ; this method was frequently associated with splenic fever, pancreatic tail injury, bleeding, etc. From October of 2007 through February of 2009, a new surgical approach linear cutter-assisted splenecto-my-was adopted by us to treat traumatic spleen ruptures. The key-pints of this method are the exposure of splenic pedicle bifur-cation and cutting the splenic pedicle near splenic parenchyma with linear cutter. The cases treated with this new method were analyzed. Methods 112 cases of traumatic spleen ruptures treated with either traditional splenectomy or new surgical approach were retrospectively analyzed and compared. Results The group treated with linear cutter-assisted splenectomy had significantly less cases of splenic fever and pancreatic leakage, and significantly shorter length of bloody drainage and length of hospital stay. Conclusion linear cutter-assisted splenectomy was associated with less complications and better outcome. This new surgical ap-proach should be widely adopted.