腹腔镜脾切除治疗外伤性脾破裂

Laparoscopic splenectomy for traumatic spleen rupture

目的探讨采用腹腔镜脾切除的方法治疗外伤性脾破裂的可行性。方法2004年8月～2005年5月我院采用腹腔镜脾切除方法治疗外伤性脾破裂8例。结果7例顺利完成腹腔镜脾切除术,1例改行手辅助腹腔镜脾切除术成功。手术时间150～200min,平均180min。术中出血量600～5500ml,平均2200ml。Ⅱ级损伤5例,Ⅲ级3例,术后恢复佳,无并发症。结论腹腔镜脾切除治疗外伤性脾破裂安全、可行。

Objective To explore the feasibility of laparoscopic splenectomy （LS） in the management of ruptured spleen. Methods Laparoscopic splenectomy was performed in 8 cases of ruptured spleen in this hospital from August 2004 to May 2005. Results Laparoscopic splenectomy was accomplished successfully in 7 cases and a conversion to hand - assisted laparoscopic splenectomy （HALS） was needed in 1 case. The operation time was 150 -200 min （mean, 180 min）. The intraoperative blood loss was 600 -5 500 ml （mean, 2 200 ml）. There were 5 cases of type Ⅱ rupture and 3 cases of type Ⅲ rupture. The postoperative recovery was uneventful and no complications were encountered. Conclusions Laparoscopic splenectomy is a safe and feasible option for the management of ruptured spleen.