腹腔镜脾切除术在巨脾脾动脉栓塞后远期治疗中的应用

Application of laparoscopic splenectomy in the treatment of massive splenomegaly long-term after splenic artery embolization

目的:探讨腹腔镜脾切除术(LS)在巨脾脾动脉栓塞(SAE)后远期治疗中的手术效果。方法:回顾性分析2014年1月至2021年12月80例因巨脾行LS的患者资料,其中SAE后远期行LS 26例(SAE组),单纯行LS 54例(LS组)。应用SPSS 26.0软件对所有数据进行分析。术中、术后相关计量资料用(^(-)x±s)表示,采用独立样本t检验;术后并发症发生率采用χ^(2)检验。P<0.05为差异有统计学意义。结果:SAE组患者手术时间明显长于LS组(P<0.05),两组患者术中出血量、术后腹腔引流管拔除时间、术后恢复进食时间和术后住院时间术后腹腔出血、腹腔感染、肺部感染、胸腔积液、发热、胰瘘、门静脉系统血栓、切口感染比较差异均无统计学意义(P>0.05)。结论:尽管手术时间延长,腹腔镜脾切除术在巨脾脾动脉栓塞后远期治疗中是安全、可行的。

Objective To investigate the effect of laparoscopic splenectomy(LS)in the long term treatment of giant splenic artery embolization(SAE).Methods Data of 80 patients with LS due to giant spleen from January 2014 to December 2021 were retrospectively analyzed,including 26 patients in the LS group(SAE group)and 54 patients in the LS group(LS group).SPSS 26.0 software was used to analyze all two groups of data.Intraoperative and postoperative relevant indicators were represented by(^(-)x±s),and independent t test was used;The incidence of postoperative complications was tested byχ^(2).P<0.05 was considered statistically significant.Results The operative time of SAE group was significantly longer than that of LS group(P<0.05),and there were no significant differences between the two groups in terms of intraoperative blood loss,postoperative abdominal drainage tube removal time,postoperative recovery feeding time,postoperative hospitalization time,postoperative abdominal bleeding,abdominal infection,pulmonary infection,pleural effusion,fever,pancreatic leakage,portal vein thrombosis,and incision infection(P>0.05).Conclusion Despite the prolonged operation time,laparoscopic splenectomy is safe and feasible in the long-term treatment of large splenic artery embolization.