腹腔镜脾切除术治疗外伤性脾破裂的体会

目的:探讨腹腔镜脾切除术治疗外伤性脾破裂的技术要点。方法:用完全腹腔镜脾切除术治疗6例外伤性脾破裂患者,其中Ⅱ级损伤3例,Ⅲ级损伤3例,3例合并其他脏器损伤。结果:6例均顺利完成手术,无中转开腹。手术时间80～150min,平均110min。术中出血200～500ml,平均350ml。术后3例单纯性脾破裂者平均住院7d,3例伴合并伤者平均住院15.6d,术后患者顺利康复,无并发症发生。结论:腹腔镜脾切除术治疗外伤性脾破裂安全、可行,但有一定的技术难度。

Experience of laparoscopic splenectomy in treatment of traumatic splenic rupture

Objective:To explore the main technical points of laparoscopic splenectomy in the management of traumatic splenic rupture.Methods:Laparoscopic splenectomy was performed in 6 cases of traumatic splenic rupture.There were 3 cases of type II rupture and 3 cases of type Ⅲ rupture.3 cases combined with other organ injury.Results:Total laparoscopic splenectomy was completed successfully in 6 cases without conversion to open surgery.The operative time was 80-150min (mean,110min).The intraoperative blood loss was 200-500ml (mean,350ml).The postoperative mean hospital stay of patients with simple splenic rupture and combined injury was 7d and 15.6d respectively.The postoperative recovery was uneventful and no surgery-related complications were observed.Conclusions:Laparoscopic splenectomy is a safe and feasible treatment for traumatic splenic rupture.But there is some technical difficulty in surgery.