腹腔镜脾切除术十年经验总结

Laparoscopic splenectomy： a ten-year experience

目的总结10年来行腹腔镜脾切除术（LS）的临床经验，探讨LS的安全性和有效性。方法从1996年4月至2006年3月连续进行了135例LS，119例为原发性和继发性脾功能亢进，16例为其他脾疾病，其中48例为巨脾。结果135例LS中因出血转行开腹脾切除术3例（2．2％），1例术后5h需作小切口开腹止血，3例术后8--18h需再次腹腔镜探查和清除脾窝积血。平均手术时间2．3h，平均失血160ml，平均术后住院6．5d。结论LS安全、有效、切实可行，适用于有脾切除指征的原发性和继发性脾功能亢进或其他脾疾病。

Objective To summarize the experiences in laparoscopic splenectomy （LS） for 135 consecutive patients in ten years, and to explore the safety and efficacy of LS. Methods Of the 135 patients undergoing LS between April 1996 and March 2006, 119 suffered from primary or secondary hypersplenism and 16 from other diseases. Forty-eight of them had massive splenomegaly. Results LS was completed in 132 patients and a conversion was necessary in 3 cases （2.2%） because of hemorrhage. One patient required a small laparotomy to stop bleeding 5 h after LS, 3 required the second laparoscopic procedure for clearing clot 8-18 h after LS. The operative duration averaged 2.3 h and the mean blood loss was 160 ml. The median postoperative hospital stay was 6.5 d. Conclusion LS is a feasible, effective and safe surgical procedure for patients who require splenectomy.