采用二级脾蒂离断法的腹腔镜脾切除术：一种高性价比的方法。
Laparoscopic splenectomy by secondary pedicle division strategy: a highly cost-effective method.
作者信息
Cai Xiu-jun, Shen Bo, Yu Hong, Liang Xiao, Zhu Lin-hua, Wang Yi-fan, Dai Yi, Yang Jin
机构信息
Institute of Micro-Invasive Surgery of Zhejiang University, Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310016, China.
出版信息
Chin Med J (Engl). 2008 Jan 20;121(2):105-7.
BACKGROUND
Laparoscopic splenectomy (LS) shows many advantages compared with open surgery except for the high cost. This study was aimed to recommend secondary pedicle division strategy as a method with high cost-effectiveness.
METHODS
From January 2003 to June 2005, 14 consecutive patients underwent laparoscopic splenectomy. The splenic pedicle was controlled by secondary pedicle division strategy in 8 cases and by Endo-GIA in the other 6 cases. A retrospective study was carried out to evaluate the operative time, blood loss, time to diet, operative morbidity, postoperative stay, and operative cost.
RESULTS
LS was performed successfully in a total of 14 cases. There was no significant difference between the two strategies in operative time, blood loss, time to diet, operative morbidity and postoperative stay. The operative cost of secondary pedicle division strategy group (RMB 8354.38 +/- 752.10) was significantly lower than that of Endo-GIA group (RMB 11053.33 +/- 602.27) (P < 0.01).
CONCLUSIONS
Laparoscopic splenectomy by secondary pedicle division strategy is a safe, effective and economical procedure with the value of popularization in developing countries.
背景
与开放手术相比，腹腔镜脾切除术（LS）除成本高外显示出许多优势。本研究旨在推荐二级脾蒂离断策略作为一种具有高成本效益的方法。
方法
2003年1月至2005年6月，连续14例患者接受腹腔镜脾切除术。8例采用二级脾蒂离断策略控制脾蒂，另6例采用Endo-GIA控制脾蒂。进行回顾性研究以评估手术时间、失血量、进食时间、手术并发症、术后住院时间和手术费用。
结果
14例患者均成功实施腹腔镜脾切除术。两种策略在手术时间、失血量、进食时间、手术并发症和术后住院时间方面无显著差异。二级脾蒂离断策略组的手术费用（8354.38±752.10元人民币）显著低于Endo-GIA组（11053.33±602.27元人民币）（P<0.01）。
结论
采用二级脾蒂离断策略的腹腔镜脾切除术是一种安全、有效且经济的手术方法，在发展中国家具有推广价值。
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