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首页> 外文期刊>Surgical Endoscopy >Laparoscopic splenectomy for blunt trauma: a safe operation following embolization.
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Laparoscopic splenectomy for blunt trauma: a safe operation following embolization.

机译：腹腔镜脾切除术治疗钝性创伤：栓塞术后安全操作。

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BACKGROUND: Embolization of the injured spleen from blunt trauma reduces the risk of continued or delayed hemorrhage in patients being treated with nonoperative management (NOM). Splenectomy is required in some patients following embolization due to continued bleeding or infarction with abscess formation. Laparoscopic splenectomy for blunt trauma can be done safely in patients following embolization. METHODS: A retrospective chart review was conducted on patients undergoing splenectomy following embolization due to blunt trauma at two level I trauma centers. Minimally invasive techniques were compared to laparotomy for operative time, operative blood loss, and postoperative length of stay. RESULTS: Eleven of 46 patients required splenectomy following embolization, eight for continued bleeding and three for abscess formation. Four of these patients had their spleens removed laparoscopically, three for continued bleeding and one for abscess formation. Patients undergoing laparoscopic splenectomy for continued bleeding had slightly longer operative times, more blood loss but shorter postoperative stay than those undergoing laparotomy. (96 versus 76 min, 500 versus 300 cc, and 4.0 versus 7.0 days, respectively). Laparoscopic removal of the abscessed spleen took 270 min compared to 55 and 90 min for the open procedures but the postoperative hospital stay was only 6 days compared to 10 and 13 days. There were no serious complications in any patients. CONCLUSION: Laparoscopic removal of the spleen following embolization for blunt trauma is safe and should be considered in patients that have persistent bleeding or are at risk for delayed bleeding, as well as patients in whom complications of infarction and abscess formation develop.
机译：背景：钝性外伤使受伤的脾栓塞可降低接受非手术治疗（NOM）的患者持续或延迟出血的风险。由于持续的出血或梗塞形成脓肿，栓塞后的某些患者需要进行脾切除术。栓塞后的患者可安全地进行腹腔镜脾切除术治疗钝性创伤。方法：回顾性分析了在两个一级创伤中心因钝性创伤栓塞后行脾切除术的患者的回顾性图表。将微创技术与开腹手术的手术时间，手术失血量和术后住院时间进行了比较。结果：46例患者中有11例在栓塞后需要行脾切除术，8例持续出血，3例脓肿形成。这些患者中有四名患者通过腹腔镜切除了脾脏，三名患者持续出血，另一名患者脓肿形成。接受腹腔镜脾切除术持续出血的患者与接受剖腹手术的患者相比，手术时间略长，出血量更多，但术后停留时间更短。 （分别为96和76分钟，500和300 cc，以及4.0和7.0天）。腹腔镜切除脓肿的脾脏需要花费270分钟，而开放手术需要55分钟和90分钟，但是术后住院时间仅为10天和13天，仅为6天。任何患者均无严重并发症。结论：栓塞后钝性损伤的腹腔镜切除脾脏是安全的，对于持续出血或有延迟出血风险的患者以及发生梗塞和脓肿形成并发症的患者应予以考虑。

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