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首页> 外文期刊>Surgical Endoscopy >Laparoscopic splenectomy: experience of a single center in a series of 300 cases.
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Laparoscopic splenectomy: experience of a single center in a series of 300 cases.

机译：腹腔镜脾切除术：300例中的单个中心的经验。

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Laparoscopic splenectomy (LS) has gradually become the technique of choice for surgical removal of the spleen. The aim of this study was to evaluate the efficacy of LS in a large cohort of patients from a single center.From March 1992 to June 2010, 300 patients underwent LS at our hospital for predominantly hematologic disorders. The first 92 cases were performed using an anterior approach, whereas in the remaining 208 cases a lateral approach with a four-trocar technique was used. Patient demographics, diagnosis, and outcomes were reviewed.Spleen volume was similar between the anterior (350 ml) and the lateral (370 ml) approaches. The lateral approach was associated with shorter operative time (60 vs. 80 min), less blood loss (30 vs. 110 ml), and no conversion (0 vs. 2.2 %) compared to the anterior approach. Reoperations were required in three patients (1.0 %) because of bleeding, subphrenic abscess, and intestinal ischemia. Postoperative complications were significantly fewer for the lateral (4.8 %) than for the anterior (31.5 %) approach and the hospital stay was shorter (3.1 vs. 5.2 days) and there was less postoperative pain. Splenectomy for hematologic malignancies resulted in a higher morbidity rate, more postoperative pain, and longer hospital stay. Overall mortality rate was 0.3 %. No late complications were observed during the 1-5-year follow-up.LS using the lateral approach with the placement of four trocars can be considered the procedure of choice for both benign and malignant diseases affecting the spleen. Extensive experience and technical standardization help to avoid surgical pitfalls, providing an adequate control of hemostasis, the excision of accessory spleens (AS), and the avoidance of parenchymal rupture.
机译：腹腔镜脾切除术（LS）已逐渐成为外科手术切除脾脏的首选技术。这项研究的目的是评估LS对来自同一中心的大量患者的疗效。从1992年3月到2010年6月，我院有300例因血液系统疾病而接受LS治疗的患者。前92例采用前路入路，而其余208例采用四套管针侧入路。回顾了患者的人口统计学，诊断和预后，前侧（350 ml）和侧向（370 ml）方法的脾脏体积相似。与前入路相比，侧入路手术时间较短（60 vs. 80 min），失血量较少（30 vs. 110 ml）且无转换（0 vs. 2.2％）。由于出血，phr下脓肿和肠缺血，三名患者（1.0％）需要再次手术。外侧入路（4.8％）的术后并发症显着少于前路（31.5％），并且住院时间更短（3.1 vs. 5.2天），并且术后疼痛更少。脾切除术治疗血液系统恶性肿瘤导致更高的发病率，更多的术后疼痛和更长的住院时间。总死亡率为0.3％。在1-5年的随访中未观察到后期并发症。使用侧向入路并放置4个套管针的LS可被视为影响脾脏的良性和恶性疾病的选择程序。丰富的经验和技术标准化有助于避免外科手术的陷阱，充分控制止血，切除辅助脾（AS）并避免实质性破裂。

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