Fan Yong, Liu Yong-Yong, Wang Ping, Wang Chen, Li Xu-Sheng, Kang Ying-Xin, Kang Bo-Xiong, Zhao Yan-Hui, Zhang You-Cheng
Department of General Surgery, Lanzhou University Second Hospital Lanzhou 730000, China.
Int J Clin Exp Med. 2015 Oct 15;8(10):19430-5. eCollection 2015.
Laparoscopy splenectomy (LS) was adopted in surgery from 1980s, it has become the main way of exploring for treating spleen diseases. Compared with conventional open surgery, LS has been gradually accepted by physicians and patients due to its advantages, including minimal surgical injury, less intraoperative blood loss, quick postoperative recovery, shorter hospital period, better cosmetic result, less risk of postoperative infections and improved postoperative quality of life Here, we try to investigate the splenic pedicle transection by using Endo-GIA (a linear stapling device) procedure and manual manipulation of secondary splenic pedicle for LS. A retrospective study was conducted on 60 patients who underwent LS. And patients were divided into two groups. 30 patients (group A) received splenic pedicle transection with Endo-GIA procedure and in the other 30 patients (group B) underwent secondary splenic pedicle transection for LS. Perioperative outcome measures of each group were recorded, including operation duration, intraoperative blood loss, postoperative flatus pass time, postoperative complications, drainage duration, hospital cost and length of hospital stay. Surgeries were successfully achieved in 60 patients. The operative duration of group A was significantly shorter than that of group B. However, group B was significantly superior over Endo-GIA group in terms of the intraoperative blood loss, postoperative flatus pass time, drainage duration, length of hospital stay and total cost of hospital stays. No significant differences were observed in postoperative fever, ascites and hyperamylasemia between two groups. Both of these two approaches for LS are safe and feasible. However, compared with Endo-GIA procedure, manual manipulation of secondary splenic pedicle for LS may leading to less intraoperative blood loss, results in less hospital expense, and hence can be widely adopted in clinical practice.
腹腔镜脾切除术（LS）自20世纪80年代开始应用于外科手术，现已成为治疗脾脏疾病的主要探索方式。与传统开放手术相比，LS因其手术创伤小、术中失血少、术后恢复快、住院时间短、美容效果好、术后感染风险低以及术后生活质量提高等优点，逐渐被医生和患者所接受。在此，我们尝试研究在LS中使用Endo - GIA（一种线性缝合器械）进行脾蒂离断及手动处理二级脾蒂的方法。对60例行LS的患者进行了回顾性研究。患者被分为两组。30例患者（A组）采用Endo - GIA进行脾蒂离断，另外30例患者（B组）行LS的二级脾蒂离断。记录每组的围手术期结果指标，包括手术时间、术中出血量、术后排气时间、术后并发症、引流时间、住院费用和住院时间。60例患者手术均成功完成。A组的手术时间明显短于B组。然而，B组在术中出血量、术后排气时间、引流时间、住院时间和住院总费用方面明显优于Endo - GIA组。两组术后发热、腹水和高淀粉酶血症方面未观察到显著差异。这两种LS方法都是安全可行的。然而，与Endo - GIA方法相比，LS中手动处理二级脾蒂可能导致术中出血量更少，住院费用更低，因此可在临床实践中广泛应用。
