经脐单孔腹腔镜脾切除术的临床应用:单中心经验总结(附视频)

Clinical application of the transumbilical single-incision laparoscopic splenectomy: single center experience

目的总结经脐单孔腹腔镜脾切除术的临床应用经验,提高腹腔镜治疗脾脏疾病的有效性和安全性。方法收集2010年3月至2013年1月13例实施经脐单孔腹腔镜脾切除术患者的临床资料进行分析,其中脾破裂1例,脾动脉瘤1例,特发性血小板减少性紫癜1例,先天性溶血合并胆囊结石1例,脾血管瘤2例,脾囊肿2例,肝硬化合并门静脉高压症5例。结果 13例患者均顺利完成手术,无中转开腹手术,平均手术时间(165±41)min,平均出血量(298±25.8)ml,其中6例术中输入血液制品。术后平均住院时间(8.8±2.7)d,1例出现进行性血红蛋白水平下降,再次行腹腔镜探查止血术,其余患者均无出血及感染等并发症发生。患者恢复均良好,切口美容效果极佳。结论经脐单孔腹腔镜脾切除术对于有丰富腹腔镜经验技术的普外科医生来说是安全可行的。

Objective：To summarize the clinical experience of the transumbilical single-incision laparoscopic splenectomy and to improve the effectiveness and safety of laparoscopic splenic surgery. Methods：From March 2010 to January 2013, 13 cases of transumbilical single-incision laparoscopic splenectomy were operated successfully, including 1 case with traumatic rupture of the spleen, 1 splenic artery aneurysm, 1 idiopathic thrombocytopenia, 1 congenital hemolytic anemia with gallbladder stone, 2 of splenic hemangioma, 2 of splenic cyst and 5 of hypersplenism secondary to portal hypertension. Results：All the operations went smoothly with mean operation time of （165±41） min, mean blood loss （298±25.8） ml, and mean postoperative hospital stay （8.8±2.7） days. 1 patient had a postoperative complication with hemoperitoneum. No other complications occurred in this small series. All patients recovered well and had a cosmetic surgical incision. Conclusion：Transumbilical single-incision laparoscopic splenectomy is safe and feasible for experienced laparoscopic surgeons.