Klingler P J, Tsiotos G G, Glaser K S, Hinder R A
Department of General Surgery, Mayo Clinic Jacksonville, Florida 32224, USA.
Surg Laparosc Endosc. 1999 Jan;9(1):1-8.
The aim of this review is to assess the indications for, and surgical approach to, laparoscopic splenectomy (LS) and to propose a recommendation for the surgical approach to LS. The reports of LS were reviewed with a detailed analysis of indications, surgical technique, and clinical outcome. Thirty-two articles including a total of 643 patients (549 adults and 94 children) were published between August 1994 and May 1997, with a mean of 20 cases per report. LS is recommended if the spleen has a maximum diameter of 20 cm. Compared to the open procedure, there are fewer perioperative complications, less morbidity, and a shorter hospital stay. The disadvantages of LS are longer operation times and less sensitivity in identifying accessory spleens. LS is not the operation of choice for hypersplenism and traumatic splenic injury.
本综述的目的是评估腹腔镜脾切除术（LS）的适应证及手术方法，并对LS的手术方法提出建议。回顾了LS的报告，并对适应证、手术技术和临床结果进行了详细分析。1994年8月至1997年5月期间发表了32篇文章，共643例患者（549例成人和94例儿童），平均每份报告20例。如果脾脏最大直径为20 cm，则推荐行LS。与开放手术相比，围手术期并发症更少，发病率更低，住院时间更短。LS的缺点是手术时间更长，识别副脾的敏感性更低。LS不是脾功能亢进和外伤性脾损伤的首选手术。
