经脐单孔腹腔镜脾部分切除在儿童脾病中的应用体会  

Application experience of single-site laparoscopic partial splenectomy in pediatric spleen diseases

作　　者：张秩坤 李中策 郑奕菲 戚士芹[2] Zhikun Zhang;Zhongce Li;Yifei Zheng;Shiqin Qi(The Fifth Clinical Medical College of Anhui Medical University,Hefei 230051,China;Department of General Surgery,Children′s Hospital Affiliated to Anhui Medical University,Hefei 230051,China)

机构地区：[1]安徽医科大学第五临床学院,合肥230051 [2]安徽医科大学附属省儿童医院普外科,合肥230051

出　　处：《中华腔镜外科杂志（电子版）》2024年第2期116-119,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的报道经脐单孔腹腔镜脾部分切除术应用于儿童脾病中的经验。方法回顾性分析2017年10月至2023年10月16例行经脐单孔腹腔镜脾部分切除术脾病患儿的临床资料。结果(1)术前临床诊断并术后病理证实:脾囊肿5例,脾错构瘤4例,脾血管瘤4例,遗传性球形红细胞增多症3例;(2)病灶位于脾上叶,行脾上叶切除5例;病灶位于脾下叶,行脾下叶切除5例;病灶位于脾中叶3例,其中2例行脾中、下叶切除,1例术中出血转为脾动脉结扎术;3例遗传性球形红细胞增多症行脾中叶、下叶、部分脾上叶切除;(3)14例顺利完成经脐单孔腹腔镜手术,2例左上腹加孔完成手术;(4)术后均顺利出院,无出血及感染等并发症,随访3~55个月,良性瘤体均无复发,遗传性球形红细胞增多症患儿贫血显著改善。结论经脐单孔腹腔镜脾部分切除术治疗儿童脾病是安全、可行的,在切除病灶的同时保留脾脏功能并具有最佳美容效果。Objective To report the experience of single-site laparoscopic partial splenectomy in the treatment of pediatric spleen diseases.Methods A retrospective analysis of clinical data was conducted for 16 children with spleen diseases who underwent single-site laparoscopic partial splenectomy from Oct.2017 to Oct.2023.Results(1)Preoperative clinical diagnoses and postoperative pathological confirmations:5 cases of splenic cysts,4 cases of splenic hamartomas,4 cases of splenic vascular malformations,and 3 cases of hereditary spherocytosis.(2)Lesions located in the upper pole or lower pole of the spleen were resected respectively in 5 cases;lesions in the middle pole were observed in 3 cases,with 2 undergoing resection of the middle and lower poles,and 1 case converting to splenic artery ligation due to intraoperative bleeding;3 cases of hereditary spherocytosis underwent resection of the middle,lower,and partial upper poles.(3)Fourteen cases were successfully completed using single-incision laparoscopic surgery,and two cases required an additional port in the left upper abdomen to complete the procedure.(4)All patients were smoothly discharged postoperatively without complications such as bleeding or infection.Follow-up ranged from 3 to 55 months,with no recurrence observed in benign tumors,and significant improvement in anemia for children with hereditary spherocytosis.Conclusion Single-incision laparoscopic partial splenectomy is a safe and feasible method for treating pediatric spleen diseases.It allows for the removal of lesions while preserving splenic function and provides optimal cosmetic outcomes.

关 键 词：儿童 脾脏疾病 脾脏部分切除术 经脐单孔腹腔镜 

分 类 号：R726.5[医药卫生—儿科]