腹腔镜脾切除术治疗血液系统疾病。

Laparoscopic splenectomy for hematologic diseases.

作者信息

Tanoue Kazuo, Okita Keishi, Akahoshi Tomohiko, Konishi Kouzou, Gotoh Norikazu, Tsutsumi Norifumi, Tomikawa Morimasa, Hashizume Makoto

机构信息

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Surgery. 2002 Jan;131(1 Suppl):S318-23. doi: 10.1067/msy.2002.120121.

DOI:10.1067/msy.2002.120121

PMID:11821831

Abstract

BACKGROUND

Laparoscopic splenectomy has been demonstrated to be technically feasible and safe for the treatment of hematologic diseases.

METHODS

The study comprised 64 consecutive patients with chronic immune thrombocytopenia purpura (ITP) who were admitted to our hospital from 1992 to 2000 and underwent laparoscopic splenectomy. Forty-one consecutive patients with ITP who underwent open splenectomy performed at the same hospital by the same surgical team between 1986 and 2000 were selected as the control group.

RESULTS

We performed laparoscopic splenectomies for ITP, hereditary spherocytosis (HS), malignant lymphoma, autoimmune hemolytic anemia, and cryoglobulinemia. Laparoscopic surgery as compared with open surgery in ITP revealed a significantly lower pain medication requirement, an earlier resumption of oral intake, and a shorter hospital stay, but a longer operative time. During the present study (range: 3.8-80 months), the cumulative rate of nonrecurrence was 67.9% at 5 years after surgery, which was similar to the rate for the previous open splenectomy.

CONCLUSIONS

Laparoscopic splenectomy is considered to be a suitable alternative therapeutic modality in the treatment of hematologic diseases.

摘要

背景

腹腔镜脾切除术已被证明在治疗血液系统疾病方面技术上可行且安全。

方法

本研究纳入了1992年至2000年期间连续收治于我院并接受腹腔镜脾切除术的64例慢性免疫性血小板减少性紫癜（ITP）患者。选取1986年至2000年期间由同一手术团队在同一家医院对41例连续接受开放性脾切除术的ITP患者作为对照组。

结果

我们对ITP、遗传性球形红细胞增多症（HS）、恶性淋巴瘤、自身免疫性溶血性贫血和冷球蛋白血症患者进行了腹腔镜脾切除术。与开放性手术相比，ITP患者接受腹腔镜手术时，止痛药物需求量显著降低，口服摄入恢复更早，住院时间更短，但手术时间更长。在本研究期间（范围：3.8 - 80个月），术后5年的累积无复发率为67.9%，与既往开放性脾切除术的复发率相似。