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首页> 外文期刊>Surgical Endoscopy >Is it worthwhile to preserve adult spleen in laparoscopic distal pancreatectomy? Perioperative and patient-reported outcome analysis
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Is it worthwhile to preserve adult spleen in laparoscopic distal pancreatectomy? Perioperative and patient-reported outcome analysis

机译：在腹腔镜远端胰腺切除术中保留成人脾脏是否值得？围手术期和患者报告的结局分析

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Background: Despite the emphasis on its role, the spleen has commonly been removed in distal pancreatectomy. We designed this study to evaluate the efficacy of spleen salvage during laparoscopic distal pancreatectomy for patients with benign and borderline malignant tumors. Materials and methods: From February 2005 to December 2010, 40 patients underwent spleen-preserving laparoscopic distal pancreatectomy (Sp-Lap DP) and 32 patients underwent laparoscopic distal pancreatosplenectomy (Lap DPS). Medical records were retrospectively reviewed, and a specially designed questionnaire was administered to the patients for the follow-up study. Results: The demographics and final diagnoses were similar between the two groups. The operative time was significantly longer in the Sp-Lap DP group (303.9 ± 136.0 versus 239.0 ± 94.9 min, p = 0.024). Patients in the Lap DPS group had more postoperative pancreatic fistulas of higher grade (p = 0.026). A higher grade of postoperative complications occurred more frequently in the Lap DPS group (p = 0.003). Consequently, postoperative hospital stay was significantly shorter for Sp-Lap DP than for Lap DPS patients (7.1 ± 2.3 versus 12.5 ± 10.8 days, p = 0.004). On the follow-up survey, episodes of common cold or flu were apparently more frequent in the Lap DPS group (p = 0.026). Despite the similar recovery period between the two groups, significantly more patients who underwent Lap DPS felt fatigue (p = 0.014) and poorer health condition (p = 0.042). Conclusions: In addition to frequent higher-grade complications and prolonged hospital stays, Lap DPS appeared to impair patient quality of life based on follow-up survey. Even an effort to preserve adult spleen in distal pancreatectomy is worthwhile.
机译：背景：尽管强调其作用，但在远端胰腺切除术中通常已去除了脾脏。我们设计了本研究，以评估腹腔镜远端胰腺切除术对良性和边缘性恶性肿瘤患者的脾救治效果。材料和方法：自2005年2月至2010年12月，40例行保留脾的腹腔镜远端胰腺切除术（Sp-Lap DP）和32例行了腹腔镜远端胰腺切除术（Lap DPS）。回顾性检查病历，并为患者进行专门设计的问卷调查以进行后续研究。结果：两组的人口统计学和最终诊断相似。 Sp-Lap DP组的手术时间明显更长（303.9±136.0分钟与239.0±94.9分钟，p = 0.024）。 Lap DPS组的患者术后胰腺瘘的等级更高（p = 0.026）。 Lap DPS组较高的术后并发症发生率（p = 0.003）。因此，Sp-Lap DP患者的术后住院时间明显短于Lap DPS患者（7.1±2.3天对12.5±10.8天，p = 0.004）。在后续调查中，Lap DPS组的普通感冒或流感发作显然更为频繁（p = 0.026）。尽管两组之间的恢复期相似，但接受Lap DPS的患者明显多于疲劳（p = 0.014）和较差的健康状况（p = 0.042）。结论：根据随访调查，除了频繁的高级别并发症和长期住院外，Lap DPS似乎还会损害患者的生活质量。即使在远端胰腺切除术中保留成人脾脏的努力也是值得的。

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