精准外科理念下的腹腔镜脾部分切除术  

Laparoscopic partial splenectomy guided by precise surgery procedures

作　　者：杨俊生 包永进 陈卫波 杨勇[1] 蔡辉华[1] 段云飞[1] 陈学敏[1] 孙冬林[1] Yang Junsheng;Bao Yongjin;Chen Weibo;Yang Yong;Cai Huihua;Duan Yunfei;Chen Xuemin;Sun Donglin(Department of Hepatopancreatobiliary Surgery,the Third Affiliated Hospital of Soochow University,Jiangsu Province 213003,China)

机构地区：[1]苏州大学附属第三医院肝胆胰外科,江苏省213003

出　　处：《中华普通外科杂志》2020年第3期219-222,共4页Chinese Journal of General Surgery

基　　金：国家自然科学基金青年项目(81602054)。

摘　　要：目的对比分析腹腔镜下脾部分切除术(laparoscopic partial splenectomy,LPS)在脾良性实体肿瘤治疗中的优势。方法回顾性分析苏州大学附属第三医院2010年1月至2018年6月期间行腹腔镜手术的脾脏良性实体肿瘤患者的临床资料。根据手术方式分为LPS组和腹腔镜下全脾切除术(laparoscopic total splenectomy,LTS)组。结果46例患者纳入研究,其中LPS组21例,LTS组25例。两组患者手术时间、术中出血量、输血率、引流时间、术后住院天数、总住院费用、术后第1天及1个月白细胞计数、术后第1天及第5天血小板计数、术后并发症(出血、发热、脾窝积液、胰瘘、静脉血栓)比较,差异均无统计学意义,但LPS组术后第5天白细胞计数、术后1个月血小板计数、血小板增多症发生率均低于LTS组,差异有统计学意义(分别t=-2.146,-2.089,χ^2=4.293,均P<0.05)。结论LPS能为脾脏良性实体肿瘤患者获益,符合精准外科发展理念。Objective To evaluate partial splenectomy(LPS)in the treatment of benign solid tumors of the spleen.Methods The clinical data of patients with benign solid tumors of spleen treated by laparoscopy from Jan 2010 to Jun 2018 in the Third Affiliated Hospital of Soochow University was retrospectively analyzed.Patients were divided into LPS group and laparoscopic total splenectomy(LTS)group.Results There were 21 cases in LPS group and 25 cases in LTS group.Differences between the two groups,operative time,blood loss,transfusion rate,maintenance of drain,postoperative hospital stay,costs,postoperative WBC and platelet count,and postoperative complications such as hemorrhage,fever,splenic fossa effusion,pancreatic fistula,venous thrombosis were statistically insignificant.However,the postoperative incidence of thrombocythemia in the LPS group were significantly lower compared to the LTS group(χ^2=4.293,P<0.05).Conclusions Patients with benign solid tumors of the spleen will benefit more from LPS compared to LTS.

关 键 词：脾脏肿瘤 脾切除术 腹腔镜 

分 类 号：R733[医药卫生—肿瘤]