Moores D C, McKee M A, Wang H, Fischer J D, Smith J W, Andrews H G
Division of Pediatric Surgery, Loma Linda University Children's Hospital 92354, USA.
J Pediatr Surg. 1995 Aug;30(8):1201-5. doi: 10.1016/0022-3468(95)90022-5.
Laparoscopic surgery is becoming widely accepted as an alternative to conventional procedures. It is becoming more and more evident that laparoscopic techniques can be applied successfully to pediatric patients. Advantages of these techniques include less postoperative pain, decreased ileus, fewer pulmonary complications, and shorter hospital stays. Elective splenectomy for hematologic disease or for staging of Hodgkin's lymphoma also appears to be amenable to laparoscopic techniques. This report details 12 consecutive splenectomies successfully performed laparoscopically since July 1993. No case required conversion to laparotomy. Each case was reviewed with respect to operative time, estimated blood loss, identification of accessory spleens, time until full oral intake, analgesia requirements, and length of stay. Factors contributing to morbidity such as ileus, pulmonary complications, and would infections were evaluated. Documentation was also reviewed for late sequelae such as intestinal obstruction and incisional hernias. These patients were compared with 20 consecutively treated patients who underwent open splenectomy in the period immediately preceding the use of laparoscopic splenectomy. Laparoscopic splenectomy, in the authors' experience, is a safe alternative to open splenectomy, has few complications, is cost effective, and has been well accepted by patients and families.
腹腔镜手术作为传统手术的替代方法正被广泛接受。越来越明显的是，腹腔镜技术能够成功应用于儿科患者。这些技术的优点包括术后疼痛减轻、肠梗阻减少、肺部并发症减少以及住院时间缩短。针对血液系统疾病或霍奇金淋巴瘤分期进行的择期脾切除术似乎也适用于腹腔镜技术。本报告详细介绍了自1993年7月以来连续成功实施的12例腹腔镜脾切除术。无一例需要转为开腹手术。对每例手术的手术时间、估计失血量、副脾的识别、完全恢复经口进食的时间、镇痛需求以及住院时间进行了评估。对肠梗阻、肺部并发症和伤口感染等导致发病的因素进行了评估。还对肠梗阻和切口疝等晚期后遗症的记录进行了审查。将这些患者与在开展腹腔镜脾切除术之前紧接着的时期内连续接受开腹脾切除术的20例患者进行了比较。根据作者的经验，腹腔镜脾切除术是开腹脾切除术的一种安全替代方法，并发症少，具有成本效益，并且已为患者及其家属所广泛接受。
