经脐隐蔽切口与传统切口腹腔镜脾切除术的比较  

Natural orifice transumbilical versus conventional incision laparoscopic splenectomy： a comparative study

作　　者：王磊[1] 刘新农[1] 李峰[1] 李扬 张光永[1] 刘少壮[1] 展翰翔[1] 胡三元[1] 

机构地区：[1]山东大学齐鲁医院普通外科,济南250012

出　　处：《中华肝胆外科杂志》2016年第1期45-47,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨经脐隐蔽切口腹腔镜脾切除术的可行性、安全性、手术技巧及临床效果。方法回顾性分析2011年11月至2014年11月山东大学齐鲁医院开展的经脐隐蔽切口腹腔镜脾切除（A组，n：9）及同期传统腹腔镜脾切除（B组，n=15）手术资料，对比两组手术时间、术中出血量、术后并发症、住院时间、切口满意程度、总住院费用等指标。纳入疾病包括免疫性血小板减少症、遗传性球形红细胞增多症及单纯性脾亢。结果24例腹腔镜手术均取得成功。两组术中出血量及住院花费差异无统计学意义[分别为（196．7±118．7）ml、（188．7±110．8）ml；（3．7±0．5）万元、（3．6±0．7）万元，P〉0．05]。经脐腹腔镜脾切除美观满意度评分明显优于LS[分别为（4．1±0．6）、（3．4±0．7），P〈0．05]；而手术时间明显长于传统腹腔镜脾切除[分别为（201．7±43．2）min、（131．0±37．1）min；P〈0．05]。术后随访3～28个月两组均无严重临床并发症发生。结论经脐隐蔽切口腹腔镜脾切除术较传统腹腔镜脾切除虽然操作时间较长，但安全可行，可以取得更好的美容效果。Objective To study the feasibility, safety, operative skills and clinical advantage of natural orifice transumbilical laparoscopic spleneetomy. Methods The clinical data of patients who under- went natural orifice transumbilical laparoscopie spleneetomy （ group A, n = 9） and conventional laparoscopic splenectomy （group B, n = 15） in our department from Nov. 2011 to Nov. 2014 were reviewed. The opera- tive time, estimated blood loss, post-operation complications, hospital stay, incision satisfaction score and total cost were compared between two groups. Patients with immune thrombocytopenia, presume hereditary splecocytosis and idiopathic hypersplenism were included. Results All the procedures were successfully carried out laparoseopically. The estimated blood loss and total cost showed no significant differences be- tween group A and group B [ （ 196.7 ± 118.7） ml vs （ 188.7 ± 110.8） ml; （3.7 ±0.5） vs （3.6 ±0.7） x 104 yuan, P 〉0. 05 ]. As to the incision satisfaction score, group A was superior to group B [ （4.1 ± 0.6） vs （3.4± 0.7） , P 〈 0.05 ]. The operation time of group A was significantly longer than that of group B [（201.7±43.2） min vs （131.0 ±37.1） min, P〈0.05]. Conclusion Natural orifice transumbilical laparoscopie splenectomy is a safe and feasible procedure with better satisfactory clinical outcomes than conventional laparoscopic splenectomy.

关 键 词：腹腔镜脾切除术 经脐隐蔽切口 传统切口 

分 类 号：R657.6[医药卫生—外科学]