腹腔镜技术在脾良性肿瘤治疗中的应用

Laparoscopic surgery for benign splenic lesions

目的评估腹腔镜全脾切除术（LTS）和腹腔镜脾部分切除术（LPS）患者的围手术期情况，探讨利用腹腔镜技术诊疗脾良性肿瘤的可行性和安全性。方法回顾性分析本院2009年12月至2016年4月行腹腔镜手术治疗的57例脾良性肿瘤患者的临床资料。根据手术方式不同将患者分为2组：腹腔镜全脾切除术组（LTS组）和腹腔镜脾部分切除术组（LPS组），收集并分析患者术前、术中和术后的相关临床资料及术后随访资料。结果与LPS组比较，LTS组手术时间更短[（97．0±22．1）min比（135．0±24．6）min，P〈0．05]，且术中出血量明显减少[（33．3±19．5）min比（90．6±55．1）min，P〈0．05]。两组患者术后住院时间、引流管放置时间及术后镇痛例数差异无统计学意义。LTS组与LPS组胰瘘和肺部感染等并发症的发生率均较低，两组差异无统计学意义。结论采用腹腔镜技术治疗脾良性肿瘤是安全可行的。

Objective TO study the safety and feasibility of laparoscopic total splenectomy （LTS） and laparoscopic partial splenectomy （LPS） in the diagnosis and treatment of benign splenic tumors by comparing the perioperative and follow-up data between these two operative approaches. Methods We retrospectively analyzed the clinical data of 57 patients who underwent laparoscopic surgery for benign splenic tumors from December 2009 to April 2016. These patients were divided into the LTS and the LPS groups. The clinical data including the preoperative, intraoperative, postoperative and follow-up data were analyzed. Results When compared with the LPS group, the LTS group had shorter operation time [ （97.0 ± 22.1 ） minvs. （135.0±24.6） min, P〈0.05] and less blood loss [（33.3 ±19.5） min vs. （90.6±55.1） min, P 〈 0.05 ] , but there were no significant differences between the two groups in the length of hospital stay, the duration of drainage tube placement, the amount of postoperative analgesics as well as the incidences of pulmonary infection, postoperative pancreatic fistula and other complications after surgery. These incidences were low in the two groups. Conclusion Laparoscopic surgery, including LTS and LPS, were safe and feasible in treating benign splenic tumors.