手辅助腹腔镜巨大脾脏切除术

Hand-assisted laparoscopic splenectomy for giant spleens.

作者信息

Borrazzo E C, Daly J M, Morrisey K P, Fischer E, Belmont M, Hogle N J, Fowler D L

机构信息

Department of Surgery, Weill Medical College of Cornell University, 525 E. 68th Street, New York, NY 10021, USA.

出版信息

Surg Endosc. 2003 Jun;17(6):918-20. doi: 10.1007/s00464-002-8946-z. Epub 2003 Mar 14.

DOI:10.1007/s00464-002-8946-z

PMID:12632136

Abstract

BACKGROUND

Laparoscopic splenectomy for massive splenomegaly is technically difficult, and the morcellated splenic tissue may be inadequate for histologic study. A hand-assisted technique may provide a technical advantage and allow removal of larger pieces of spleen.

METHODS

Patients who underwent hand-assisted laparoscopic splenectomy for massive splenomegaly were reviewed. Demographic information, operative data, and outcomes data were tabulated.

RESULTS

Sixteen patients met these criteria. Mean age was 56 years (range, 35-78 years). Operating time averaged 240 min (range, 165-360 min), and median blood loss was 425 cc (range, 100-1800 cc). There were no conversions to an open procedure. Mean weight of extracted spleens was 2008 g (range, 543-4090 g). Postoperative length of stay averaged 3.3 days (range, 2-7 days). There was one postoperative complication (6.25%) and no mortality.

CONCLUSIONS

Hand-assisted laparoscopic splenectomy for massive splenomegaly is feasible and safe while preserving the recovery benefits of minimal access surgery. It provides an adequate specimen for histologic study.

摘要

背景

对于巨脾进行腹腔镜脾切除术在技术上具有挑战性，且切碎的脾组织可能不足以进行组织学研究。手辅助技术可能具有技术优势，并允许切除更大块的脾脏。

方法

对接受手辅助腹腔镜巨脾切除术的患者进行回顾。将人口统计学信息、手术数据和结果数据制成表格。

结果

16例患者符合这些标准。平均年龄为56岁（范围35 - 78岁）。手术时间平均为240分钟（范围165 - 360分钟），中位失血量为425毫升（范围100 - 1800毫升）。无中转开腹手术。切除脾脏的平均重量为2008克（范围543 - 4090克）。术后住院时间平均为3.3天（范围2 - 7天）。有1例术后并发症（6.25%），无死亡病例。