改良的手助腹腔镜脾切除术（附26例分析）

目的：探讨改良的手助腹腔镜脾切除术的安全性、微创性及治疗的有效性。方法：回顾分析2006年4月—2008年12月完成的26例改良的腹腔镜下脾切除术患者的临床资料,其中特发性血小板减少性紫癜2例,脾囊肿3例,脾脉管瘤2例,脾血管瘤2例,溶血性贫血1例,脾淋巴瘤2例,肝硬化脾亢、脾肿大10例,不明原因脾肿大3例,脾破裂伴发热1例。合并胆囊结石5例。结果：26例全部由改良的手助腹腔镜完成脾切除术,无中转开腹,平均脾脏切除时间为130min,术中平均出血量为244mL,术后平均住院时间为6.6d,无手术直接导致的并发症及死亡。结论：改良的手助腹腔镜下脾切除术是安全、有效的新方法,适用于多种脾脏疾病的脾切除手术。

Improved Hand-Assisted Laparoscopic Splenectomy: a Report of 26 Cases

Objective： To evaluate the safety,micro-invasion and efficiency of improved hand-assisted laparoscopic splenectomy（HALS）.Methods： We reviewed the perioperative outcomes of 26 patients who underwent improved hand-assisted laparoscopic splenectomy during April 2006 to December 2008,in which 2 patients were with idiopathic thrombocytopenic purpera（ITP）,3 patients with cyst of spleen,2 patients with spleen hemangioma,2 patients with spleen angioma,one patient with autoimmune hemolytic anemia,2 patients with lymphoma,10 patients with cirrhosis,splenomegaly and hypersplenism,3 patients with unknown splenomegaly,one patient with splenic rupture and fever,and 5 patients were concomitantly with gallstone.Results： All patients were underwent improved hand-assisted laparoscopic splenectomy and no one was converted to open surgery.The average time of spelencotomy were 130min.The average amount of bleeding during operation was 244ml and the average days of postoperative discharging were 6.6.No complication or death directly resulted from HALS were happened.Conclusions： Improved hand-assisted laparoscopic splenectomy is a new method of splenectomy with high safety and efficiency,which is suitable for diseases of the spleen.