Perger Lena, Aprahamian Charles J, Muensterer Oliver J, Chong Albert J, Lacher Martin, Yu David, Yannam Govardhana R, Harmon Carroll M
Division of Pediatric Surgery, Department of Surgery, Scott and White Hospital, 2401 S. 31st St., Temple, TX 76508, USA.
J Laparoendosc Adv Surg Tech A. 2013 Feb;23(2):162-5. doi: 10.1089/lap.2012.0333. Epub 2013 Jan 17.
BACKGROUND/PURPOSE: Single-incision pediatric endosurgery (SIPES) is gaining popularity. The aim of this study was to review the authors' experience with SIPES splenectomy and compare it with conventional laparoscopic splenectomy.
After institutional review board approval, data on SIPES splenectomy in children were collected prospectively. The study group was compared with a control group of patients who were retrospectively identified as having undergone conventional laparoscopic splenectomy during the same time period.
Sixteen children underwent SIPES splenectomy. Ages ranged from 1 to 15 years, with a median of 7 years, and weights were between 10 and 70 kg, with a median of 24 kg. The control group was similar in age and weight characteristics. The most common diagnoses were hereditary spherocytosis, sickle cell disease, and immune thrombocytopenic purpura. There were two conversions to open splenectomy in the SIPES group and one in the laparoscopic group. Operative times were 40-190 minutes (median, 84 minutes) in the SIPES group and 51-154 minutes (median, 99 minutes) in the conventional laparoscopic group.
The SIPES technique is well suited for splenectomy. Despite instruments and camera being in-line, working angles are not compromised, and visualization is adequate. Operating time and hospital stay are comparable to those with standard laparoscopic splenectomy, but the cosmetic result may be superior.
背景/目的：单切口小儿内镜手术（SIPES）正日益受到欢迎。本研究的目的是回顾作者进行SIPES脾切除术的经验，并将其与传统腹腔镜脾切除术进行比较。
经机构审查委员会批准后，前瞻性收集小儿SIPES脾切除术的数据。将研究组与同期回顾性确定接受传统腹腔镜脾切除术的对照组患者进行比较。
16名儿童接受了SIPES脾切除术。年龄范围为1至15岁，中位数为7岁，体重在10至70千克之间，中位数为24千克。对照组在年龄和体重特征方面与之相似。最常见的诊断为遗传性球形红细胞增多症、镰状细胞病和免疫性血小板减少性紫癜。SIPES组有2例转为开放性脾切除术，腹腔镜组有1例。SIPES组手术时间为40至190分钟（中位数为84分钟），传统腹腔镜组为51至154分钟（中位数为99分钟）。
SIPES技术非常适合脾切除术。尽管器械和摄像头在同一直线上，但工作角度不受影响，视野也足够清晰。手术时间和住院时间与标准腹腔镜脾切除术相当，但美容效果可能更好。
