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对于选定的患有血管瘤或囊肿的患者,部分脾切除术优于全脾切除术。

Partial Splenectomy is Superior to Total Splenectomy for Selected Patients with Hemangiomas or Cysts.

作者信息

Wang Lei, Xu Jianwei, Li Feng, Zhan Hanxiang, Liu Han, Chen Wei, Hu Sanyuan

机构信息

Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, Shandong, China.

出版信息

World J Surg. 2017 May;41(5):1281-1286. doi: 10.1007/s00268-016-3794-5.

Abstract

BACKGROUND

The superiority of partial splenectomy (PS) as a treatment for benign tumors has not well been confirmed. This study aimed to identify the short- and long-term outcomes of PS, to compare laparoscopic and laparotomic PS, and to demonstrate whether the effects of PS are superior to that of total splenectomy (TS).

METHODS

Patients with either a hemangioma or cyst who underwent PS or TS from 2009 to 2015 at Qilu Hospital of Shandong University were included. Clinical parameters were collected and analyzed.

RESULTS

A total of 17 patients underwent PS were collected, including 2 men and 15 women with a mean age of 43.9 ± 11.3 years old. Patients who underwent laparoscopic PS (9 cases) had a longer operative time and shorter postoperative hospital stay than those who underwent laparotomy (8 cases). Compared with TS (22 cases), PS significantly decreased the incidence of thrombocytosis, shortened time until drainage removal, and shortened postoperative hospital stay. After an average follow-up of 34.8 months, patients who underwent TS showed a higher incidence of thrombocytosis and splenic vein thrombosis compared with patients underwent PS.

CONCLUSIONS

PS is technically feasible and provides favorable short- and long-term outcomes for selected patients with either a hemangioma or cyst compared with TS. Laparoscopic PS shows lower morbidity and equal therapeutic efficacy compared with laparotomic PS and can be widely performed.

摘要

背景

部分脾切除术(PS)作为良性肿瘤治疗方法的优越性尚未得到充分证实。本研究旨在确定PS的短期和长期疗效,比较腹腔镜下和开腹PS,并证明PS的效果是否优于全脾切除术(TS)。

方法

纳入2009年至2015年在山东大学齐鲁医院接受PS或TS治疗的血管瘤或囊肿患者。收集并分析临床参数。

结果

共收集到17例行PS的患者,包括2例男性和15例女性,平均年龄43.9±11.3岁。接受腹腔镜PS(9例)的患者手术时间长于开腹手术(8例),术后住院时间短于开腹手术患者。与TS组(22例)相比,PS组血小板增多症发生率显著降低,引流管拔除时间缩短,术后住院时间缩短。平均随访34.8个月后,与接受PS的患者相比,接受TS的患者血小板增多症和脾静脉血栓形成的发生率更高。

结论

与TS相比,PS在技术上可行,为选定的血管瘤或囊肿患者提供了良好的短期和长期疗效。与开腹PS相比,腹腔镜PS的发病率更低,治疗效果相当,可广泛开展。

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