| Objective:Laparoscopic splenectomy has become an effective method to cure splenomegaly and hypersplenism caused by various diseases.However,because of the inherent limitations of laparoscopic surgery and the limitations of surgeons,we think that laparoscopic splenectomy has narrow indicationgs compared with traditional laparotomy ever.In recent years,with the constant improvement of the laparoscopic technique level,and the development of interventional surgery,the indication of laparoscopic splenectomy is expanding.This study review clinical data of20 cases accepted laparoscopic splenectomy,to summarize the indications,related technical points of laparoscopic splenectomy and joint surgery of laparoscopic splenectomy,and compare the clinical benefit of the 26 patients who received open splenectomy.Method : From September 2015 to March 2016,laparoscopic splenectomy was performed on 20 patients with massive splenomegaly in our hospital,compared with 26 patients who underwent open splenectomy(group 2).Perioperative outcomes of these patients werecompared.Result:Compared with patients in group 2,the patients in group 1required more operative time(207.9+44.2vs176.3+64.8,P=0.013<0.05),less blood transfusion(20.0%vs 30.7%,P=0.018<0.05),and a shorter postoperative hospital stay(7.0+2.1vs11.1+2.2,P=0.002<0.05);furthermore,patients in group 1 had less estimated blood loss(225.0+56.2vs420.9+177.3,P=0.013<0.05)、 fewer complications(10%vs30.7%,p=0.021<0.05)and less pain in postoperative days.The patient’s white blood cells and platelets rise rapidly after received LS.No statistically significant difference was found in the patients,spleen size and spleen weight.Conclusion:Laparoscopic splenectomy of massive splenomegaly can be completed smoothly and safely,by putting reasonable surgical posture,establishing open pneumoperitoneum and following the operating procedure that deal with bottom of spleen first,then ligate splenic artery and mantapaka hilum of spleen at last.Besides the use of splenic artery embolism,make it more feasible.The contraindications were considered by people turned to indications.LS have more excellent clinical benefit,in addition it is safe and reliable.With the development of minimally invasive techniques in the future,the majority of patients who need to remove the spleen can be done through the laparoscope. |
