二级脾蒂分离法腔镜脾切除术治疗特发性血小板减少性紫癜

目的介绍该科应用腹腔镜脾切除术治疗特发性血小板减少性紫癜(idiopathic thrombocytopenic purprua,ITP)的经验,以及利用可吸收夹行腔镜下脾蒂处理的体会。方法20例ITP患者,通过解剖二级脾蒂的方法,用可吸收夹夹闭脾血管,完成腔镜脾切除手术。结果20例手术患者,无1例中转开腹,无术后严重并发症,其中16例患者用可吸收夹顺利完成腔镜脾切除,4例患者术中脾蒂改为Endo-GIA切割关闭。结论在具备丰富的腔镜手术经验的基础上,二级脾蒂分离法腔镜脾切除术是一种安全有效的技术,并具有创伤小、恢复快、费用低、并发症少等优点。手术前和手术中需要严格把握手术适应证以及做好相应准备。

Laparoscopic splenectomy by dissecting secondary braches of splenic pedicle in patients of idiopathic thrombocytopenic prupura

Objective To introduce our experience in laparoscopic splenectomy(LS)in patients of idiopathic thrombocytopenic prupura(ITP),and the experience of management of spleen pedicle with biological clamps.Methods LSs were performed in 20 ITP patients by dissecting secondary braches of splenic pedicle and using biological clamps to block them.Results LSs were performed safely with no conversion to open surgery and no severe postoperative complication.Sixteen patients were smoothly performed with biological clamps.Four cases were converted to traditional LS with Endo-GIA.Conclusions Based on rich experience of LS,full preparation and cautious choices of patients,laparoscopic splenectomy is a safe,effective,minimally invasive and low complication method with management of spleen pedicle using biological clamps.