腹腔镜与开腹脾切除术在脾淋巴瘤治疗中的对比研究  

Comparative study of laparoscopic versus open splenectomy for primary splenic lymphoma

作　　者：陈鸿[1] 孙明浩 周晓俊[1] CHEN Hong;SUN Ming-hao;ZHOU Xiao-jun(Department of General Surgery,Suzhou Dushuhu Public Hospital,Dushuhu Public Hospital Affiliated to Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院独墅湖院区普通外科,江苏苏州215006

出　　处：《腹腔镜外科杂志》2021年第2期101-104,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜脾切除术(LS)与开腹脾切除术(OS)治疗原发性脾脏淋巴瘤(PSL)的临床疗效。方法:回顾分析2012年9月至2018年1月手术治疗的35例PSL患者的临床资料,其中18例行OS(开腹组),17例行LS(腹腔镜组,包括手助式)。对比分析两组手术时间、术中出血量、术后镇痛时间、术后下床活动时间、术后通气时间等指标。结果:腹腔镜组术中出血量、术后镇痛时间、术后下床活动时间、术后通气时间、术后住院时间均优于开腹组(P<0.05),但手术时间长于开腹组,差异有统计学意义(P<0.05);两组术后引流管留置时间、并发症发生率差异无统计学意义(P>0.05)。结论:PSL诊断困难,脾切除术既可取得病理明确诊断,又是有效的治疗手段,与OS相比,LS具有创伤小、术后康复快、切口美观等优点,是PSL患者行脾切除的良好选择。Objective:To investigate the clinical efficacy of laparoscopic splenectomy(LS) and open splenectomy(OS) in the treatment of primary splenic lymphoma(PSL).Methods:The clinical data of 35 patients with PSL treated by surgery from Sep.2012 to Jan.2018 were analyzed retrospectively.Of those cases,18 were treated by OS and LS was conducted in 17 cases(hand-assisted laparoscopy included).The operative time,intraoperative blood loss,the postoperative analgesia time,postoperative ambulation time,postoperative ventilation time and so on were compared between the two groups.Results:The intraoperative blood loss,the postoperative analgesia time,postoperative ambulation time,postoperative ventilation time and the postoperative hospital stay in LS group were less than those in OS group while the operation duration in LS group was longer than that in OS group with statistically significant difference(P<0.05).There was no statistically significant difference in the drainage time and the postoperative complications between two groups(P>0.05).Conclusions:PSL is difficult to diagnose.The operation may obtain the pathological diagnosis support,also may have the certain therapeutic effect.Compared to the OS,LS has advantages of few trauma,quick recovery after surgery and cosmetic incision,and provides a good choice for PSL patients.

关 键 词：原发性脾脏淋巴瘤 脾切除术 腹腔镜检查 剖腹术 对比研究 

分 类 号：R657.6[医药卫生—外科学]