完全腹腔镜下脾切除术的临床应用(附63例报道)

目的:探讨腹腔镜脾切除术(laparoscopic splenectomy,LS)的临床应用。方法:我们2001年至2008年共实施LS63例,其中特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)42例,门脉高压继发性脾功能亢进11例,白血病5例。结果:全部病例均在腹腔镜下完成手术,无中转开腹。平均手术时间140min,术中平均失血120ml,术后出血1例,每天约20ml,保守治疗12d后痊愈;术后胃漏1例,手术缝合及引流后痊愈。术后平均住院6d。结论:LS具有创伤小,患者恢复快、痛苦轻和住院时间短等优点,适用于脾脏体积正常至中度增大的有切脾指征的各类患者。

The clinical application of laparoscopic splenectomy:with a report of 63 cases

Objective:To study the clinical application of laparoscopic splenectomy(LS).Methods:63 cases were performed LS from 2001 to 2008,aming them 42 cases were idiopathic thrombocytopenic purpura patients,11 cases were Portal hypertension patients,5 cases were Leukemia patients.Results:All operations were successfully performed.Average operation time was 140min,average blood loss in operation was 120ml,and average hospitalization after operation was 6d.One case occurred haemonhage after operation,and was cured after 12 days conservative medicine treatment.One case of postoperative sfomach leatage was cured.Conclusions:LS is a safe and feasible minimal invasive surgery technique.It has advantages of minimal injury,rapid recovery,mini-incision and shorter hospitalization.