免装置手助腹腔镜脾切除门奇静脉断流术(附29例报告)

Hand-assisted Laparoscopic Splenectomy with Porta-azygos Disconnection without Hand-port Devices:Report of 29 Cases

目的探讨免装置手助腹腔镜脾切除门奇静脉断流术的手术技术和可行性。方法采用免装置手助腹腔镜行脾切除门奇断流术29例。结果1例中转开腹手术,28例手术成功。手术时间70～300min,平均135min。术中出血50～1500mL,平均270mL。切除脾重500～1300g,平均810g。术后住院时间5～16d,平均9.2d。手助切口愈合良好,3例出现并发症,无手术死亡。结论免装置手助腹腔镜行脾切除门奇断流术不但安全可行,而且具有微创手术的优点,疗效满意。

Objective To explore the technique and feasibility of hand-assisted laparoscopic splenectomy （HALS） with porta-azygos disconnection without hand-port devices. Methods 29 patients were underwent HALS with porta-azygos disconnection without hand-port devices. Results HALS with porta-azygos disconnection was successful performed in 28 cases,and one case was converted to open surgery. Mean operation time was 135 min （rang,70-300 min） and mean blood loss was 270 mL （rang, 50 - 1 500 mL）. Mean splenic weight was 810 g （rang, 500- 1 300 g）. The average postoperative hospital stay was 9.2 days （rang,5-16 days）. Postoperative complication occurred in 3 cases and there was no operation mortality. Conclusion HALS with porta-azygos disconnection without hand-port devices is a safe, feasible and effective procedure for portal hypertension,with the advantage of minimally invasive surgery.