Shabahang Hossein, Maddah Ghodratollah, Tavassoli Alireza, Jangjoo Ali, Alvandipour Mina, Abdollahi Abbas, Noorshafiee Sajjad
Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Iran.
Surg Laparosc Endosc Percutan Tech. 2012 Apr;22(2):136-8. doi: 10.1097/SLE.0b013e318246d9a4.
Laparoscopic splenectomy (LS) is frequently performed for spleen removal under pathologic conditions. The aim of this study was to evaluate whether ligasure is superior to clip ligation during LS. In a simple randomized prospective study, 40 patients who were candidates for splenectomy were randomly assigned to 2 groups of clip and ligasure. Operating time, need for transfusion, intraoperative and postoperative bleeding, open conversion, and postoperative complications were evaluated. Operating time was 115.4 min (SD 15.24) in the clip group and 100.6 min (SD 16.05) in the ligasure group (P=0.005). Bleeding volume was 150.9 mL (SD 26.2) in the clip group and 131.7 mL (SD 25.1) in the ligasure group (P=0.025). In both groups, there was no need for transfusion and no conversion to the open approach. Although both clip and ligasure can be used for vascular control in LS, hemostasis is simply and easily achieved with little dissection using the ligasure method. Therefore, ligasure is superior to clip in cases of LS.
腹腔镜脾切除术（LS）常用于在病理情况下切除脾脏。本研究的目的是评估在LS手术中结扎速即纱是否优于钛夹结扎。在一项简单随机前瞻性研究中，40例有脾切除指征的患者被随机分为钛夹组和结扎速即纱组。评估手术时间、输血需求、术中和术后出血情况、中转开腹及术后并发症。钛夹组手术时间为115.4分钟（标准差15.24），结扎速即纱组为100.6分钟（标准差16.05）（P = 0.005）。钛夹组出血量为150.9毫升（标准差26.2），结扎速即纱组为131.7毫升（标准差25.1）（P = 0.025）。两组均无需输血，也未中转开腹。虽然钛夹和结扎速即纱均可用于LS中的血管控制，但使用结扎速即纱方法只需很少的解剖操作就能简单轻松地实现止血。因此，在LS病例中，结扎速即纱优于钛夹。
