腹腔镜手术治疗脾囊肿7例分析

Laparoscopic treatment for splenic cyst:an analysis of 7 cases.

目的 介绍应用腹腔镜手术治疗脾囊肿的方法及其临床效果。方法 自 1994年 1月至 2 0 0 3年 6月 ,第二军医大学长海医院采用腹腔镜手术治疗 7例脾囊肿。囊肿位于脾下极 3例 ,脾体中间部 2例 ,脾上极 2例。行囊肿去顶引流 3例 ,脾切除 4例。结果 手术均成功 ,3例囊肿开窗引流术手术时间分别为 2 5min、30min及 5 5min ;4例行脾切除者手术时间分别为 4 5min、5 5min、5 5min及 80min。囊肿开窗引流术术中几乎无出血 ;脾切除术术中出血量均不超过 5 0mL。所有病人术后第 1天均可恢复饮食并下床活动。行开窗引流者术后 2～ 3d出院 ,脾切除者术后住院 4～ 5d。 3例开窗引流者分别随访 8年、7年、1年 ,未见囊肿复发。结论 采用腹腔镜技术治疗脾囊肿 ,具有术后痛苦小、恢复快、住院时间短的优点 ,有望成为脾囊肿外科治疗的首选措施。

Objective To introduce laparoscopic treatment for splenic cyst and its clinical effects. Methods From January 1994 to June 2003, 7 cases of splenic cyst underwent laparoscopic treatment in Shanghai Changhai Hospital. The cyst involved lower ploe in 3 cases, middle in 2 cases, and upper pole in 2 cases. Three cases were performed laparoscopic unroofing of the cyst wall and 4 cases were performed laparoscopic splenectomy. Results All the operations were accomplished successfully. The operation time for unroofing in three cases was 25min, 30min, and 55min respectively. The time of splenectomy for the other four cases was 45min, 55min, 55min and 80min respectively. The intraoperative bleeding in unroofing was trace and was less than 50mL in splenectomy. All the patients could resume oral intake and motility at the first day postoperatively. The hospital stay of these two operations was 2～3 days and 4～5days respectively. Those three cases undergoing unroofing were followed up for a period of 1year, 7 years and 8 years respectively, and no recurrence occurred. Conclusion The laparoscopic treatment for splenic cyst has shown its advantages of less pain, fast recovery and short hospital stay. It might be the first choice of surgical treatment for splenic cyst.