Misiakos Evangelos P, Bagias George, Liakakos Theodore, Machairas Anastasios
3 Department of Surgery, Attikon University Hospital, University of Athens School of Medicine, Attica, 12462 Athens, Greece.
Clinic for General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, Germany.
World J Gastrointest Endosc. 2017 Sep 16;9(9):428-437. doi: 10.4253/wjge.v9.i9.428.
Since early 1990's, when it was inaugurally introduced, laparoscopic splenectomy has been performed with excellent results in terms of intraoperative and postoperative complications. Nowadays laparoscopic splenectomy is the approach of choice for both benign and malignant diseases of the spleen. However some contraindications still apply. The evolution of the technology has allowed though, cases which were considered to be absolute contraindications for performing a minimal invasive procedure to be treated with modified laparoscopic approaches. Moreover, the introduction of advanced laparoscopic tools for ligation resulted in less intraoperative complications. Today, laparoscopic splenectomy is considered safe, with better outcomes in comparison to open splenectomy, and the increased experience of surgeons allows operative times comparable to those of an open splenectomy. In this review we discuss the indications and the contraindications of laparoscopic splenectomy. Moreover we analyze the standard and modified surgical approaches, and we evaluate the short-term and long-term outcomes.
自20世纪90年代初首次引入以来，腹腔镜脾切除术在术中及术后并发症方面均取得了优异的效果。如今，腹腔镜脾切除术是治疗脾脏良恶性疾病的首选方法。然而，仍存在一些禁忌症。不过，技术的发展使得一些曾被认为是进行微创手术绝对禁忌症的病例能够采用改良腹腔镜手术方法进行治疗。此外，先进的腹腔镜结扎工具的引入减少了术中并发症。如今，腹腔镜脾切除术被认为是安全的，与开放性脾切除术相比效果更好，并且外科医生经验的增加使得手术时间与开放性脾切除术相当。在本综述中，我们讨论了腹腔镜脾切除术的适应症和禁忌症。此外，我们分析了标准和改良手术方法，并评估了短期和长期结果。
