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Laparoscopic splenectomy for massive splenomegaly in benign hematological diseases

机译：腹腔镜脾切除术治疗良性血液病大块脾肿大

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Background: Laparoscopic splenectomy has become the standard of care for benign hematological disease affecting the spleen; its role in massive splenomegaly remains controversial. In this study, we evaluated the outcome of laparoscopic splenectomies in terms of spleen size in a group of 83 patients of benign hematological diseases. Methods: From July 2003 to December 2009, 83 patients underwent laparoscopic splenectomy for various benign hematological diseases. The data were recorded and analyzed in a retrospective manner. The patients were divided in to two groups according to the spleen weight; group I < 2,000 g (n = 54) and group II > 2,000 g (n = 29). Age, sex, hematological condition, operative time, estimated blood loss, conversion to open surgery, splenic weight, length of hospital stay, time to liquid diet, and morbidity were all recorded. Results: Laparoscopic splenectomy was completed in 79 patients (95.2 %). Operative time (p = 0.01) and estimated blood loss (p = 0.001) was more in group II. The length of hospital stay (p = 0.05) and the postoperative morbidity (p = 0.001) also were significantly more in the second group. There was no mortality. Conclusions: Laparoscopic splenectomy is possible and safe for massive splenomegaly in hematological disease (>2,000 g), but it needs longer operative time and hospital stay.
机译：背景：腹腔镜脾切除术已成为影响脾脏的良性血液病的标准治疗方法。它在大规模脾肿大中的作用仍存在争议。在这项研究中，我们评估了83例良性血液病患者的腹腔镜脾脏切除术的脾脏大小。方法：从2003年7月至2009年12月，对83例因各种良性血液病而进行的腹腔镜脾切除术。记录数据并以追溯方式进行分析。根据脾脏重量将患者分为两组。 I组<2,000 g（n = 54），II组> 2,000 g（n = 29）。年龄，性别，血液学状况，手术时间，估计失血量，开腹手术转换率，脾脏重量，住院时间，流食时间和发病率均被记录下来。结果：79例患者完成了腹腔镜脾切除术（95.2％）。第二组的手术时间（p = 0.01）和估计的失血量（p = 0.001）更多。第二组的住院时间（p = 0.05）和术后发病率（p = 0.001）也显着增加。没有死亡。结论：腹腔镜脾切除术对于大面积脾脏肿大（> 2,000 g）的血液系统疾病可能是安全的，但需要更长的手术时间和住院时间。

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