腹腔镜脾部分切除术治疗脾脏实性肿瘤的临床分析

Laparoscopic partial splenectomy for splenic solid lesions

目的探讨腹腔镜脾部分切除术的可行性、安全性及治疗效果。方法对2015年1月至2017年2月我院收治的脾肿瘤行腹腔镜脾部分切除术的患者资料进行回顾性分析。结果6例脾肿瘤患者中男4例，女2例，年龄28～58岁（平均年龄44．7岁），5例患者经查体发现，1例因腹部不适就诊发现，瘤体最大径5．0～8．3cm（平均5．9cm），位于上极2例，位于下极4例，手术均在腹腔镜下完成，手术时间120～240min（平均时间150min），出血50～1400ml，平均出血375ml，1例输注新鲜冰冻血浆800ml，均未输异体红细胞。无中转开腹病例，无术后主要并发症发生。术后病理提示5例脾血管瘤，1例脾血管内皮瘤。随访3～28个月（平均18．7个月）全部患者未见肿瘤复发。结论对于非脾门区的脾脏良性或交界性肿瘤，腹腔镜脾部分切除术是一种可靠、安全的治疗方法。

Objective To analyze the safety and clinical effects of laparoscopic partial splenectomy for splenic solid benign lesions. Methods Retrospective analysis was made on patients with splenic solid benign tumor admitted from Jan 2015 to Feb 2017. Results 6 patients （4 males, 2 females） underwent successful partial splenectomy for splenic tumors. Mean patient age was 44. 7 years （range, 28 -58 years）. 5 patients were diagnosed by wellness examinations, 1 patient had abdominal discomfort. The diameter of tumors ranged from 5.0 to 8.3 cm. Tumors were located in the superior lobes in 2 cases and the others were located in the inferior lobes. The operation times were 120 - 240 min and intraoperative blood loss was 50 - 1 400 ml （mean, 375 ml ）. Laparoscopic procedure was successful in all patients without major complications. Postoperative pathology showed hemangioma in 5 cases and hemangioendothelioma in one patient. After 3 to 28 months follow-up no patients experienced recurrence. Conclusions Laparoscopic partial splenectomy is safe and effective in patients with focal benign splenic lesion that was located at the edge of the spleen or in the upper or lower pole of the spleen.