腹腔镜脾部分切除术（附八例报告）

Laparoscpic partial splenectomy： Report of 8 cases

目的探讨腹腔镜脾部分切除术治疗脾脏良性肿瘤的安全性。方法2009年1月至2014年8月，对8例术前CT或MRI检查明确为脾脏良性肿瘤的病人实施腹腔镜脾部分切除术，肿瘤直径5．2～9．1cm，平均直径6．9cm，2例位于脾脏上极，6例位于脾脏下极。其中脾脏囊肿6例，脾脏血管瘤2例。结果8例均于腹腔镜下完成脾脏部分切除，无中转开腹病例，标本均经劈脐纵行小切口取出。手术时间为115-280min，平均166．3min。出血量为100-600ml，均未输血。术后腹腔引流时间3～5d，无腹腔出血、胰漏、腹腔感染等并发症。术后住院4～6d。结论腹腔镜脾部分切除术治疗位于脾脏一侧的良性肿瘤安全可行。虽然技术上较全脾切除费时费力，但保留了部分脾脏及功能，有其重要的临床意义，对年轻病人尤其如此。

Objective To discuss the security of operation of laparoscopic partial splenectomy. Methods Medical records of 8 patients with benign splenic tumor were reviewed retrospectively. The patients were diagnosed with CT or MRI and treated with laparoscopic partial splenectomy in our hospital from January 2009 to August 2014. The diameter of the tumors ranged from 5.2 to 9. 1 cm （mean, 6. 9 cm）. In operation, pneumoperitoneum was established through the inferior umbilical fold with Veress insufflation needle. The upper pole or anus perineum blood vessels were isolated and clipped at the hilum of spleen. The spleen was removed partially from ischemia line. Results All of the 8 operations were completed by laparoscopy, and no patient converted to open operation. Duration of operation was from 115 to 280 rain （mean, 166. 3 min）. Intraoperative blood loss was from 100 - 600 mL. After the procedure, abdominal drainage was maintained for 3 to 5 days. The hospital stay of the patients was 4 to 6 days. None of them had pancreatic injury, pancreatic fistula, hemorrhage, or abdominal infection. Conclusions Laparoscopic partial splenectomy＇is safe to treat benign splenic tumors.