Zeng Shuming, Wang Weiwei, Chen Wenying, Xiao Jianbo
Department of Surgery, The Forth Hospital of Zhangzhou, Fujian, China.
Department of Hepato-Biliary and Pancreatic Surgery, The People's Hospital of Tongliang District, Chongqing, China.
Wideochir Inne Tech Maloinwazyjne. 2024 Jun;19(2):211-222. doi: 10.5114/wiitm.2024.139988. Epub 2024 May 27.
The aim of the article was too investigate and compare the feasibility, safety, and early postoperative recovery associated with laparoscopic partial splenectomy (LPS) and open partial splenectomy (OPS) in patients with benign splenic tumours and traumatic splenic rupture.
A retrospective analysis was conducted on clinical data from 110 patients undergoing splenic resection at our hospital between March 2019 and May 2022. Among them, 35 patients underwent OPS, 25 underwent LPS for traumatic splenic rupture, while 50 patients with benign splenic tumours underwent either OPS (n = 20) or LPS (n = 30). Preoperative, intraoperative, and postoperative data were collected and compared. Statistical analysis was conducted using SPSS software.
There was no significant difference in the general data between the 2 groups of patients with benign splenic tumours and those with splenic trauma. Among patients with traumatic splenic rupture, the OPS group had a shorter operation time (p < 0.05). Regardless of whether they had traumatic splenic rupture or benign splenic tumours, the LPS group required less postoperative analgesia and had a shorter defecation recovery time (p < 0.05). Additionally, the LPS group displayed lower white blood cell count, white blood cell/lymphocyte ratio (WLR), neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), C-reactive protein (CRP), calcitonin (PCT), and interleukin-6 (IL-6) than the OPS group on the first and third days post-surgery (p < 0.05).
In comparison to OPS, LPS presents significant advantages, including minimal surgical trauma, a reduced early postoperative inflammatory response, milder wound pain, and a faster recovery of gastrointestinal function.
本文旨在研究和比较腹腔镜脾部分切除术（LPS）与开放性脾部分切除术（OPS）在良性脾肿瘤和外伤性脾破裂患者中的可行性、安全性及术后早期恢复情况。
对2019年3月至2022年5月在我院接受脾切除术的110例患者的临床资料进行回顾性分析。其中，35例行OPS，25例因外伤性脾破裂行LPS，50例良性脾肿瘤患者分别行OPS（n = 20）或LPS（n = 30）。收集并比较术前、术中和术后数据。使用SPSS软件进行统计分析。
两组良性脾肿瘤患者与脾外伤患者的一般资料无显著差异。在外伤性脾破裂患者中，OPS组手术时间较短（p < 0.05）。无论外伤性脾破裂还是良性脾肿瘤患者，LPS组术后镇痛需求较少，排便恢复时间较短（p < 0.05）。此外，术后第1天和第3天，LPS组白细胞计数、白细胞/淋巴细胞比值（WLR）、中性粒细胞/淋巴细胞比值（NLR）、单核细胞/淋巴细胞比值（MLR）、C反应蛋白（CRP）、降钙素原（PCT）和白细胞介素-6（IL-6）均低于OPS组（p < 0.05）。
与OPS相比，LPS具有显著优势，包括手术创伤小、术后早期炎症反应减轻、伤口疼痛较轻以及胃肠功能恢复较快。
