腔镜直线切割闭合器在贲门周围血管离断术中的应用  

Laparoscopic closer in splenectomy and pericardical devascularization： a clinical study

作　　者：李军辉[1] 曹罡[1] 张焱[1] 白育花 张莉[1] 刘海燕[1] 杨荔[1] 杨文彬[1] 

机构地区：[1]西安交通大学医学院第二附属医院普通外科,西安710004

出　　处：《腹部外科》2015年第6期386-388,398,共4页Journal of Abdominal Surgery

基　　金：国家自然科学基金（81472246）;陕西省自然科学基础研究计划项目（s2013JC101182）

摘　　要：目的探讨应用切割闭合器辅助进行脾切除、贲门周围血管离断术的方法及其较传统手术的优点。方法自2012年5月至2014年12月将56例拟行脾切除、贲门周围血管离断术的病人完全随机分为切割闭合器组（28例）和传统手术组（28例）。比较两组病人基本资料、围手术期相关指标以及随访资料。结果两组病人一般资料差异无统计学意义。切割闭合器组与传统手术组手术时间分别为（62．50±16．03）min和（172．6±25．23）min、术中出血量分别为（252．00±34．58）ml和（569．00±80．62）ml、术后住院时间分别为（14．80±1．99）d和（16．80±2．10）d、术后胰漏发生率1／28和8／28，以及平均腹腔引流量分别为（256．00±25．03）ml和（287．00±26．27）ml，两组相比差异有统计学意义。切割闭合器组术后短期再出血率明显降低，但与传统手术组相比差异无统计学意义。结论在脾切除及贲门周围血管离断术中，切割闭合器可明显降低手术时间、术中出血量及术后住院时间，值得进一步推广应用，术后长期再出血率需进一步观察。Objective To investigate the method and advantage of clinical application of laparoscopie closer in spleneetomy and pericardial devascularization compared to the traditional operation Methods A total of 56 patients with cirrhotic portal hypertension undergoing splenectomy and pericardial devascularization were retrospectively divided into closer group （CLO, n = 28） and traditional operation group （TRA, n = 28）. The general data, perioperative data and follow-up data were analyzed and compared between the two groups. Results There was no significant difference in general data between the two groups. The operative time, volume of intraoperative bleeding, postoperative hospital stay, the incidence of pancreatic fistula and volume of drainage in the CLO group were all significantly reduced as compared with those in the TRA group. The incidence of short-term recurrent gastrointestinal hemorrhage was significantly lower in the TRA group, but there was no significant difference between the two groups. Conclusions The application of laparoscopic closer in splenectomy and pericardial devascularization for portal hypertension is safe and feasible.

关 键 词：腔镜直线切割闭合器 脾切除术 贲门周围血管离断术 门静脉高压症 

分 类 号：R657.6[医药卫生—外科学]