手助腹腔镜脾切除(附8例报告)

目的探讨手助腹腔镜脾切除的可行性和安全性。方法对特发性血小板减少性紫癜（idiopathicthrombocytopenic purpera，ITP）3例，脾血管瘤1例，海洋性贫血1例，再生障碍性贫血1例，肝硬变脾肿大、脾功能亢进2例，采用手助腹腔镜行脾切除术。结果8例手助腹腔镜脾切除获得成功，平均手术时间为148min，平均出血量370mL，平均脾重478g。术后全组均未发生严重并发症，术后平均住院日为9d。结论手助腹腔镜脾切除是安全可行的，降低手术难度，有效控制出血，缩短手术时间，是值得选择的微创脾切除方式。

Hand-assisted laparoscopic splenectomy: a report of 8 cases

[Objective] The study the feasibility and safety of hand-assisted laparoscopic splenectomy. [Methoils] 8 patients underwent hand-assisted laparoscopic splenectomy including idiopathic thrombocytopenic purpera in 3 cases, splenic hemangioma in one case, thalassemia in one case, aplastic anemia in one case, cirrhotic splenomegaly in two cases. The operation was completed by hand-assisted laparoscopy. [Results] The operation was successful in 8 patients. Mean surgical time was 148 minutes. Mean blood loss was 370 mL. Mean spleen weight was 478 g. No serious postoperative complications occurred. The mean postoperative hospital stay was 9 days. [Conclusions] Hand-assisted laparoscopic splenectomy is feasible and safe. It is worth selecting minimally invasive method to benefit from reducing operative difficulty and shortening operative time and applying immediate hemostasis.