利用腹腔镜技术改进开腹脾切除术的操作流程
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朱安龙 E-mail:zhuanlone@hotmail.com

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R 657.6

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黑龙江省自然科学基金(D2007-64);黑龙江省博士后基金(LBH-Z05184);黎介寿院士肠道屏障研究专项基金(LJS_2009023)。


An improved procedure of open splenectomy by addition of laparoscopic technology
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    摘要:

    目的:探讨将腹腔镜脾切除术的操作流程应用于开腹脾切除术的借鉴价值。
    方法:总结以往的腹腔镜脾切除术, 设计新的开腹脾切除术的流程(改进开腹脾切除术)。选择61例脾切除术病例, 分为传统开腹组和改进手术组, 统计手术时间,术中出血量,术后24 h引流量,术后住院时间,手术费用和并发症,比较两组之间差异。
    结果:传统手术组手术时间(97.3±23.6)min,术中出血量(264.4±46.6)mL, 24 h引流量(285.5±76.5)mL。改进开腹手术组:手术时间(52±13.7)min,术中出血量(105.0±31.0)mL, 24 h引流量(110.3±39.5)mL;上述指标两组均有统计学差异(均P<0.05)。两组术后并发症差异无统计学意义(P>0.05),改进手术组无术中大出血和胰瘘发生,改进手术组的术中治疗费用较传统开腹组高(P<0.05),两组术后住院时间差异无统计学意义(P>0.05)。
    结论:改进后的开腹脾切除术在控制手术时间和出血风险上具有优势。合理地应用先进手术器械可以更好地实现微创理念。

     

    Abstract:

    Objective:To investigate the value of applying the procedure of laparoscopic splenectomy (LS) in open splenectomy.
    Methods:We summarized the features of LS and designed an improved procedure of open splenectomy. Sixty-one cases were divided into traditional splenectomy group(TS) and improved splenectomy group(IS).  The operation time(OT), volume of bleeding during splenectomy(VB), anount of drainage of first day after operation(DF), length of hospital stay after operation(LS) and operation cost(OC) were compared between the 2 groups. 
    Results:Traditional group: OT(97.3±23.6)min, VB(264.4±466)mL and DF(285.5±76.5)mL. Improved group: OT(52±13.7)min, VB(105.0±31.0)mL and DF(110.3±39.5)mL; there was significant  difference between the 2 groups in OT,VB and DF. There were no cases with severe bleeding or pancreatic fistula in improved group. The improved group had higher OC(P<0.05). There was no difference in LS(P>0.05).
    Conclusions:Improved open splenectomy has a certain advantage in operation time and blood loss. This experience suggests that with the use of advanced surgical instruments, open splenectomy can be performed with the concept of mininal trauma.

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朱安龙| 朴大勋| 侯彦伟| 尹雪峰| 许军| 姜洪池.利用腹腔镜技术改进开腹脾切除术的操作流程[J].中国普通外科杂志,2011,20(3):282-285.

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  • 收稿日期:2009-12-08
  • 最后修改日期:2010-09-25
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  • 在线发布日期: 2011-03-15
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