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单纯腹腔镜脾切除术治疗镰状细胞病:50例儿科病例报告

Laparoscopic Splenectomy Alone for Sickle Cell Disease: Account of 50 paediatric cases.

作者信息

Al-Balushi Zainab N, Bhatti Khalid M, Ehsan Muhammad T, Al-Shaqsi Yousuf, Al-Sharji Nawal A R, Mady Hatem A A, Sherif Mahmoud H

机构信息

Department of Surgery, Sultan Qaboos University Hospital, Muscat, Oman.

Department of Anaesthesia & Intensive Care, Sultan Qaboos University Hospital, Muscat, Oman.

出版信息

Sultan Qaboos Univ Med J. 2016 Nov;16(4):e482-e486. doi: 10.18295/squmj.2016.16.04.013. Epub 2016 Nov 30.

Abstract

OBJECTIVES

In Oman, the most frequent indication for a splenectomy in children is sickle cell disease (SCD), which is one of the most common haematological disorders in the Gulf region. This study aimed to describe paediatric laparoscopic splenectomies alone for SCD at a tertiary hospital in Oman.

METHODS

This study was conducted between February 2010 and October 2015 at the Sultan Qaboos University Hospital, Muscat, Oman. The medical records of all children aged ≤15 years old undergoing splenectomies during the study period were reviewed.

RESULTS

A total of 71 children underwent laparoscopic splenectomies during the study period; of these, 50 children (28 male and 22 female) underwent laparoscopic splenectomies alone for SCD. The children's weight ranged between 11-43 kg. The most common indication for a splenectomy was a recurrent splenic sequestration crisis (92%). Surgically removed spleens weighed between 155-1,200 g and measured between 9-22 cm. Operative times ranged between 66-204 minutes and intraoperative blood loss ranged between 10-800 mL. One patient required conversion to an open splenectomy. Postoperative complications were noted in only four patients. The median hospital stay duration was three days.

CONCLUSION

Among this cohort, the mean operating time was comparable to that reported in the international literature. In addition, rates of conversion and postoperative complications were very low. These findings indicate that a laparoscopic splenectomy alone in paediatric patients with SCD is a feasible option.

摘要

目的

在阿曼,儿童脾切除术最常见的指征是镰状细胞病(SCD),该病是海湾地区最常见的血液系统疾病之一。本研究旨在描述阿曼一家三级医院中仅针对SCD进行的小儿腹腔镜脾切除术。

方法

本研究于2010年2月至2015年10月在阿曼马斯喀特的苏丹卡布斯大学医院进行。回顾了研究期间所有年龄≤15岁接受脾切除术的儿童的病历。

结果

研究期间共有71名儿童接受了腹腔镜脾切除术;其中,50名儿童(28名男性和22名女性)仅因SCD接受了腹腔镜脾切除术。儿童体重在11 - 43千克之间。脾切除术最常见的指征是反复脾滞留危机(92%)。手术切除的脾脏重量在155 - 1200克之间,尺寸在9 - 22厘米之间。手术时间在66 - 204分钟之间,术中失血量在10 - 800毫升之间。一名患者需要转为开放脾切除术。仅4名患者出现术后并发症。中位住院时间为三天。

结论

在该队列中,平均手术时间与国际文献报道的相当。此外,中转率和术后并发症发生率非常低。这些发现表明,对于患有SCD的小儿患者,仅进行腹腔镜脾切除术是一种可行的选择。

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