A Clinical Comparative Study Of Emergency Laparoscopy Splenectomy And Emergency Open Splenectomy For The Treatment Of Traumatic Splenic Rupture

Objective:By compared and analyzed the clinical data of emergency laparoscopic splenectomy and open splenectomy for the treatment of traumatic splenic rupture,to discuss the indications and clinical efficacy of emergency laparoscopic splenectomy in the treatment of traumatic splenic rupture,which provided the basis for the selection of surgical scheme.Method:The clinical data of 63 patients with traumatic splenic rupture treated surgically from December 2013 to December 2018 were retrospectively analyzed,in the First Hospital of Jilin University They were divided into two groups(emergency laparoscopic group 32 cases and emergency open group 31 cases).The preoperative general data(including age,sex,heart rate,systolic pressure,diastolic pressure,traumatic causes,the time from operation to injury,and time of operation,BMI,preoperative hemoglobin,injury grade)were compared between the two groups.Intraoperative related data(operation time,total bleeding volume,whether blood transfusion,intraoperative use of autologous blood).Postoperative clinical data(including hospitalization costs,post-operative hospitalization time,abdominal drainage volume on the first day after operation,drainage fluid amylase on the second day after operation,recovery time of gastrointestinal function,extraction time of abdominal drainage tube,post-operative clinical data,the frequency of using analgesics).And the occurrence of common complications after operation.The data were compared using t test,chi-square test,etc.,and processed with software SPSS23.0.Results:There was no significant difference in preoperative general date between the emergency LS group and the emergency open group(P>0.05).In terms of surgical data,there was a statistically significant difference in the operation time and the use of autologous blood between the emergency LS group and the emergency OS group.(P<0.05);postoperative related data,the difference between the emergency LS group and the emergency OS group in the postoperative hospital stay days and gastrointestinal function recovery time were statistically significant;in the postoperative complications,there was no significant difference between the emergency LS group and the emergency OS(P>0.05).Conclusion:Emergency LS has obvious advantages for the treatment of traumatic spleen rupture and emergency LS is safe and feasible:(1)When the emergency LS treats traumatic spleen rupture,the degree of spleen damage can be clearly observed,and the laparoscope has a magnifying effect,which is convenient for treating fine blood vessels.(2)Emergency LS treatment of traumatic spleen rupture is in line with the theory of injury control,rapid recovery concept,with postoperative pain,early eating,short hospital time,etc.(3)Under the premise of strict control of surgical indications,it is safe and feasible for the experienced laparoscopic team.Emergency laparoscopic splenectomy for the treatment of traumatic spleen rupture has broad prospects and is worthy of clinical promotion.