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脾脏硬化性血管瘤样结节性转化的治疗选择

Treatment options for sclerosing angiomatoid nodular transformation of spleen.

作者信息

Jin Yanwen, Hu Hajie, Regmi Parbatraj, Li Fuyu, Cheng Nansheng

机构信息

Department of Biliary Surgery, West China Hospital, Sichuan University, PR China.

Department of Biliary Surgery, West China Hospital, Sichuan University, PR China.

出版信息

HPB (Oxford). 2020 Nov;22(11):1577-1582. doi: 10.1016/j.hpb.2020.01.014. Epub 2020 Feb 13.

Abstract

BACKGROUND

To summarise the clinical features of Sclerosing angiomatoid nodular transformation (SANT) of the spleen and to compare the efficacy of three different surgical treatments.

METHODS

We performed a retrospective analysis of patients with SANT of spleen treated at our center from 2009 to 2018. We compared the efficacy and safety of three different types of surgical procedures. ANOVA and the chi-square test were used for statistical analysis.

RESULTS

A total of 37 patients were included. Most (35/37; 94.6%) were asymptomatic. A number presented as obscure boundary lesions such that malignancy could not be excluded. Open splenectomy was performed for 12 patients, laparoscopic splenectomy for 12 patients and laparoscopic partial splenectomy for 13 patients. Operation time (P = 0.355), blood loss (P = 0.135), length of hospital stay after operation (P = 0.271) and postoperative complications (P = 0.502) were comparable between the three groups. Duration of drainage tube placement was significantly longer in laparoscopic partial splenectomy patients (P = 0.006). Peak platelet count after operation was significantly lower in laparoscopic partial splenectomy patients (P < 0.001).

CONCLUSION

Laparoscopic partial splenectomy appears to be a technically feasible and therapeutically effective approach for SANT.

摘要

背景

总结脾脏硬化性血管瘤样结节性转化(SANT)的临床特征,并比较三种不同手术治疗方法的疗效。

方法

我们对2009年至2018年在本中心接受治疗的脾脏SANT患者进行了回顾性分析。我们比较了三种不同手术方式的疗效和安全性。采用方差分析和卡方检验进行统计分析。

结果

共纳入37例患者。大多数(35/37;94.6%)无症状。一些表现为边界不清的病变,无法排除恶性肿瘤。12例行开放性脾切除术,12例行腹腔镜脾切除术,13例行腹腔镜部分脾切除术。三组患者的手术时间(P = 0.355)、失血量(P = 0.135)、术后住院时间(P = 0.271)和术后并发症(P = 0.502)相当。腹腔镜部分脾切除术患者的引流管放置时间明显更长(P = 0.006)。腹腔镜部分脾切除术患者术后血小板计数峰值明显更低(P < 0.001)。

结论

腹腔镜部分脾切除术似乎是一种治疗SANT技术上可行且有效的方法。

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