后外侧入路腹腔镜脾切除术：附37例报告

Application of posterolateral approach in laparoseopic splenectomy： a report of 37 eases

目的探讨后外侧入路腹腔镜脾切除术（LS）的临床应用价值。方法1994年12月至2005年12月我院在开展16例前入路LS的基础上，采用后外侧入路完成37例LS，回顾分析后外侧入路LS的临床资料。结果除1例因套圈套扎脾蒂失败，遂扩大切口将脾脏提至腹壁按常规手术处理脾蒂外，其余手术均在完全腹腔镜下完成。切除脾脏长径7～18cm，7例病人发现副脾（18．9％）。术后切口感染1例，平均手术时间为130min，平均术中失血量80ml，平均术后住院5．5d。结论后外侧入路有利于LS操作，是一种值得推广的手术入路。

Objective To explore clinical value of posterolateral approach in laparoscopic splenectomy （LS）. Methods We have performed a total of 53 LS between 1994 and 2005. In our initial experience, 16 patients underwent surgery with anterior approach. In the second series of 37 patients,we used a posterolateral approach. The clinical data of 37 patient receiving LS with a posterolateral approach were ＇retrospectively analyzed. Results The range of splenic length was 7-18 cm. Accessory spleen was found in 7 patients（18. 9%）. All operations were successful and no conversion to laparotomy occurred. Post-operation infection of incisional wound occurred in 1 patient. The average operative duration was 130 min,the average intraoperative blood loss was 80 ml and the mean postoperative stay was 5.5 days. Conclusions Posterolateral approach contributes to manipulation in LS and is deserved to spread.