Samama G, Le Roux Y, Brefort J L, Reman O, Leporrier M
Groupement Caennais pour la Coelio-Chirurgie (G3C), Service de Chirurgie Viscérale et Digestive, CHU, Caen.
Ann Chir. 1995;49(6):482-6.
In order to evaluate the place of the laparoscopic approach in splenectomy for haematological disease, the authors prospectively studied a series of 25 consecutive patients requiring splenectomy. There were 11 cases of thrombocytopenic purpura, 9 lymphomas, 2 cases of herediary spherocytosis, 1 Felty syndrome, 1 idiopathic myelofibrosis and 1 Hodgkin disease. Twelve patients (48%) underwent an immediate conventional procedure for huge splenomegaly (10), obesity (1), unavailability of video-equipment. Thirteen patients (52%) underwent a laparoscopic approach. Five of these operations were converted into a conventional approach for various reasons. In the other 8 patients, the spleen was completely released laparoscopically. In two of these 8 patients, the spleen was removed via a sub-pubic Pfannenstiel incision due toits volume. The last 6 spleens (24%) were removed in a plastic bag, corresponding to 5 cases of one thrombocytopenic purpura and one Hodgkin disease. None of these patients were obese. These results suggest that the laparoscopic approach is indicated in case of moderate splenemegaly in non-obese patients.
为了评估腹腔镜手术在血液系统疾病脾切除术中的地位，作者前瞻性地研究了连续25例需要行脾切除术的患者。其中血小板减少性紫癜11例，淋巴瘤9例，遗传性球形红细胞增多症2例，费尔蒂综合征1例，特发性骨髓纤维化1例，霍奇金病1例。12例患者（48%）因巨脾（10例）、肥胖（1例）、无视频设备等原因立即接受了传统手术。13例患者（52%）接受了腹腔镜手术。其中5例手术因各种原因转为传统手术。在另外8例患者中，脾脏通过腹腔镜完全游离。在这8例患者中的2例，由于脾脏体积较大，经耻骨下Pfannenstiel切口取出。最后6个脾脏（24%）装在塑料袋中取出，分别对应1例血小板减少性紫癜和1例霍奇金病。这些患者均不肥胖。这些结果表明，对于非肥胖患者的中度脾肿大，腹腔镜手术是可行的。
