脾肿大等级判断建议与手术方式选择

Suggestion of grade judgment and selection of surgical methods for splenomegaly

与开腹脾切除术(OS)相比,腹腔镜脾切除术(LS因具有创伤小、恢复快、住院时间短等微创手术优势,已广泛应用于正常大小脾脏或稍大脾脏的切除。随着临床LS的广泛应用,其适应证也拓展至巨脾的切除,但当前针对巨脾能否成功实施LS的大小极限与手术指征的选择尚存在较大争议。故此,建议将我国脾肿大"三度法"修改为"四度法",以期指导选择恰当的手术方式。

Laparoscopic splenectomy(LS)is superior to open splenectomy(OS)because of advantages of minimal invasion,such as small trauma,rapid recovery,and short hospitalizing time,widely used in the resection of normalsized or moderately enlarged spleens.With the wide application of LS,the indications have been extended to the excision of massive spleens.However,there is still a tremendous controversy about the upper limit of splenic size which can be in accord with a requirement of LS and selection of surgical indications.Taking the issues into account,the authors recommended that the splenomegaly should be divided into"four degrees"rather than"three degrees"used today widely in order to guide the selection of appropriate surgical methods.