腹腔镜脾部分切除术治疗脾脏良性疾病体会  

Experience of laparoscopic partial splenectomy for benign splenic diseases

作　　者：高胜强 姜静华[1] 俞世安[1] 罗建生[1] GAO Shengqiang;JIANG Jinghua;YU Shian;LUO Jiansheng(Department of Hepatobiliary and Pancreatic Surgery,Jinhua Central Hospital,Jinhua,Zhejiang 321000,China)

机构地区：[1]金华市中心医院肝胆胰外科,浙江金华321000

出　　处：《肝胆胰外科杂志》2022年第4期214-216,共3页Journal of Hepatopancreatobiliary Surgery

基　　金：金华市重点科学技术研究计划项目(2021-3-056);金华市中心医院中青年科研启动基金项目(JY2020-2-03)。

摘　　要：目的 总结腹腔镜脾部分切除术治疗脾脏良性疾病的经验和体会。方法 回顾性分析2014年1月至2020年12月在金华市中心医院14例行腹腔镜脾部分切除术的患者临床资料。结果 14例中脾脏上叶切除8例,脾脏下叶切除6例,均顺利完成腹腔镜手术,无中转开腹,其中2例在3D腹腔镜下完成。术后病理:脾囊肿6例,血管瘤4例,脉管瘤2例,脾破裂2例。平均病灶最大径(5.5±2.4)cm,平均手术时间(65.7±23.1)min,平均术中出血量(85.7±33.3)mL,平均术后腹腔引流时间(3.4±0.3)d,术后平均住院时间(4.6±1.1)d。术后无腹腔出血及腹腔感染等相关并发症,随访3~24个月,肿瘤患者未见复发。结论 腹腹腔镜脾部分切除术治疗脾脏良性疾病是安全、可行的,在切除病灶的同时保留了正常脾脏功能。术中对于二级脾蒂的分离解剖是关键,对于脾脏病变显露差的患者可以采用3D腹腔镜手术。objective To summarize the experience of laparoscopic partial splenectomy for benign splenic diseases. Methods Clinical data of 14 patients who underwent laparoscopic partial splenectomy in Jinhua Central Hospital from Jan. 2014 to Dec. 2020 were retrospectively analyzed. Results Among the 14 cases, 8 had upper splenic lobectomy and 6 had lower splenic lobectomy. Laparoscopic surgery was successfully completed without conversion to laparotomy, of which, 2 cases were completed under 3D laparoscopy. Postoperative pathology: splenic cysts in 6 cases, hemangioma in 4 cases, angioma in 2 cases and splenic rupture in 2 cases. The average lesion diameter was(5.5±2.4)cm, the average operative time was(65.7±23.1)min, the intraoperative blood loss was(85.7±33.3)mL, the average postoperative drainage was(3.4±0.3)d, and the average postoperative hospitalization time was(4.6±1.1)d. There was no postoperative bleeding or abdominal infection. The follow-up time was 3 to 24 months. No tumor recurrence occured. Conclusion For treatment of benign splenic diseases, laparoscopic partial splenectomy is safe and feasible, and the normal spleen function is preserved while removing the lesion. Intraoperative separation and anatomy of the secondary splenic pedicle is the key. For patients with poor exposure of splenic lesions, 3D laparoscopic surgery can be used.

关 键 词：脾脏良性疾病 脾脏部分切除术 腹腔镜手术 

分 类 号：R657.6[医药卫生—外科学]