Yee J C, Akpata M O
Department of Surgery, Hotel Dieu of St. Joseph, Windsor, Ont.
Can J Surg. 1995 Feb;38(1):73-6.
The traditional method of splenectomy involves a 7- to 10-cm abdominal incision, with its attendant morbidity that includes sepsis. Recently, the laparoscopic technique has been adopted for splenectomy. Many surgeons still believe that laparoscopic splenectomy should be carried out only for idiopathic thrombocytopenia purpura and Hodgkin's disease with a normal-sized spleen. A 16-year-old girl with marked splenomegaly (spleen size for times normal and weighing 600 g) due to congenital spherocytosis underwent laparoscopic splenectomy and retrieval of the spleen through the umbilical trocar site. Preoperative arterial embolization was not used, and the operative blood loss was estimated to be only 250 mL. Her postoperative course was uncomplicated, and she was discharged on the 4th postoperative day. The operative technique is described and the advantages of laparoscopic splenectomy are discussed.
传统的脾切除术方法需要做一个7至10厘米的腹部切口,随之而来的并发症包括败血症。最近,腹腔镜技术已被应用于脾切除术。许多外科医生仍然认为,腹腔镜脾切除术仅应针对特发性血小板减少性紫癜和脾脏大小正常的霍奇金病进行。一名16岁因先天性球形红细胞增多症导致脾脏明显肿大(脾脏大小为正常的数倍且重600克)的女孩接受了腹腔镜脾切除术,并通过脐部套管针部位取出脾脏。术前未进行动脉栓塞,估计手术失血量仅为250毫升。她术后恢复过程顺利,术后第4天出院。本文描述了手术技术并讨论了腹腔镜脾切除术的优点。