The Feasibility And Efficacy Of In Situ Secondary Spleen Pedicle Amputation In Laparoscopic Splenectomy For Traumatic Spleen Rupture

Objective:To study the practicability, efficacy and safety of amputation of in situ secondary spleen pedicle in laparoscopic splenectomy for traumatic spleen rupture.Methods:70 patients with traumatic spleen rupture in our hospital received the procedure of splenectomy from June 2013 to June 2013, in which 35 patients received laparoscopic splenectomy, and the other 35 cases received open operation. All cases were confirmed preoperatively by abdominal CT scan as spleen injury accompanied by abdominal cavity hemorrhage. Every patient was documented clearly with vital signs, the time from injured to be operated, the total and intraoperative spleen blood loss, operation time, postoperative flow volume, postoperative hemoglobin albumin, and platelet, anus ventilation time, the length of hospital stay and postoperative complications. Though comparing these data described above, we intend to evaluate the practicability, efficacy and safety of amputation of in situ secondary spleen pedicle in laparoscopic splenectomy for traumatic spleen rupture.Results:There were 35 cases in each group with no significant differences in age and sexual. While, there was significant difference in the time of the total operation (150±35min VS 137±28min, P<0.001) and the treatment of splenic artery (20.4±2.4min VS 22.4±1.4min, P<0.001) between the two groups. In the aspect of postoperative 72hours’flow volume, anus ventilation time,the experimental group was obviously better than the control group, (74±37ml VS 143±58ml; 58.5±8.1h VS 75.5±7.1h; respectively, and all p<0.05). However, significant difference was found in the aspect of postoperative albumin, platelet counting, and the length of hospital stay between the two groups. Meanwhile, what impressing us most was the low rate of complication in the experimental group.Conclusion:The laparoscopic splenectomy by the amputation of in situ secondary spleen pedicle for traumatic spleen rupture was safe, practicable and effective, which can be seemed as a procedure with fast recovery and less complications, and recommended as a wider application.