腹腔镜脾切除术：200多例手术的结果及经验教训

Laparoscopic splenectomy: outcomes and lessons learned from over 200 cases.

作者信息

Park A E, Birgisson G, Mastrangelo M J, Marcaccio M J, Witzke D B

机构信息

Department of Surgery, University of Kentucky Chandler Medical Center, Lexington, KY, USA.

出版信息

Surgery. 2000 Oct;128(4):660-7. doi: 10.1067/msy.2000.109065.

DOI:10.1067/msy.2000.109065

PMID:11015100

Abstract

BACKGROUND

In this study of laparoscopic splenectomy (LS), we evaluate prospectively gathered perioperative patient data and review lessons learned in the evolution of this procedure.

METHODS

At 2 university medical centers between November 1993 and March 2000, there were 203 patients (122 female patients and 81 male patients) who underwent LS after preoperative evaluation.

RESULTS

LS was successfully completed in 197 patients (97%). The mean operative time was 145.5 minutes and the length of stay averaged 2.7 days with 143 (70.4%) staying less than 48 hours. The most common indication was idiopathic thrombocytopenic purpura (ITP). Six patients required conversion to open splenectomy (OS), with only 2 conversions in the last 163 cases. No deaths were attributed to the procedure. Complications occurred in 19 patients (9.3%). Thirty accessory spleens were identified in 25 patients (12.3%). Seventeen patients (8.4%) underwent concomitant procedures, most commonly cholecystectomy.

CONCLUSIONS

LS by the lateral approach is both safe and feasible in patients of all ages.

摘要

背景

在这项关于腹腔镜脾切除术（LS）的研究中，我们前瞻性地评估了围手术期患者数据，并回顾了该手术发展过程中的经验教训。

方法

在1993年11月至2000年3月期间，两所大学医学中心共有203例患者（122例女性患者和81例男性患者）在术前评估后接受了LS。

结果

197例患者（97%）成功完成了LS。平均手术时间为145.5分钟，平均住院时间为2.7天，其中143例（70.4%）住院时间少于48小时。最常见的适应证是特发性血小板减少性紫癜（ITP）。6例患者需要转为开放性脾切除术（OS），在最后163例病例中仅有2例转为开放手术。该手术无死亡病例。19例患者（9.3%）出现并发症。25例患者（12.3%）发现30个副脾。17例患者（8.4%）接受了同期手术，最常见的是胆囊切除术。