经脐单部位腹腔镜脾部分切除术治疗儿童脾囊肿  

Transumbilical Single-site Laparoscopic Partial Splenectomy for Splenic Cysts in Children

作　　者：孔萌 贾金华 刘传阳 张士松[1] 刘红真[1] Kong Meng;Jia Jinhua;Liu Chuanyang(Department of General Surgery,Shandong University Affiliated Children’s Hospital,Jinan Children’s Hospital,Jinan 250022,China)

机构地区：[1]山东大学附属儿童医院,济南市儿童医院普外科,济南250022

出　　处：《中国微创外科杂志》2025年第3期185-189,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：山东省自然科学基金面上项目(ZR2022MH229);山东省医药卫生科技面上项目(202406020138);济南市卫生健康委员会科技计划项目(2023-1-53,2022-2-157)。

摘　　要：目的探讨经脐单部位腹腔镜脾部分切除术治疗儿童脾囊肿的安全性和可行性。方法回顾性分析2021年1月~2024年4月5例脾囊肿资料,囊肿长径6~11 cm。脐部纵切口长约2 cm,“品”字形置入3个5 mm trocar作为观察孔和2个操作孔,行脾上极(4例)或下极(1例)切除术。结果5例均顺利完成手术,无中转开腹手术,1例术中输注悬浮红细胞。手术时间100~250 min,平均162 min;术中失血量30~200 ml,平均72 ml;术后引流时间2~3 d;术后住院时间4~8 d,平均6.4 d。无并发症。1例术后1周血小板轻度升高(434×10^(9)/L),2周后复查自行降至正常。术后病理检查均为脾囊肿。术后随访6~44个月,平均28.4月,无血小板升高、囊肿复发、残脾坏死、静脉血栓及切口疝等并发症。结论经脐单部位腹腔镜脾部分切除术治疗儿童脾囊肿安全可行。Objective To explore the safety and feasibility of transumbilical single-site laparoscopic partial splenectomy for pediatric splenic cysts.Methods A retrospective analysis was conducted on 5 cases of splenic cysts from January 2021 to April 2024,with cyst diameters ranging from 6 cm to 11 cm.A vertical incision approximately 2 cm in length was made at the umbilicus,and three 5 mm trocars were inserted in a“triangle”shape,one for observation and two for operation.Splenectomy of the upper pole(4 cases)or lower pole(1 case)was performed.Results The operations were successfully completed in all the 5 cases without conversion to open surgery.One case required intraoperative transfusion of suspended red blood cells.The operation time was 100-250 min(mean,162 min),the intraoperative blood loss was 30-200 ml(mean,72 ml),the postoperative drainage time was 2-3 d,and the postoperative hospital stay was 4-8 d(mean,6.4 d).No complications were observed.One case had mild thrombocytosis(434×10^(9)/L)at one week postoperatively,which returned to normal upon re-examination two weeks later.Postoperative pathological examination confirmed splenic cysts.Follow-ups ranged for 6-44 months,with an average of 28.4 months.No complications such as thrombocytosis,cyst recurrence,residual splenic necrosis,venous thrombosis,or incisional hernia were reported.Conclusion Transumbilical single-site laparoscopic partial splenectomy is safe and feasible for treating pediatric splenic cysts.

关 键 词：脾部分切除 腹腔镜手术 经脐单部位手术 脾囊肿 儿童 

分 类 号：R73[医药卫生—肿瘤]