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中华普外科手术学杂志(电子版) ›› 2024, Vol. 18 ›› Issue (03) : 319 -322. doi: 10.3877/cma.j.issn.1674-3946.2024.03.022

论著

隧道法行腹腔镜下脾切除术的临床研究
吴鹏1, 许维1, 王壮1, 郑世海1, 宋劲松1,()   
  1. 1. 431700 湖北天门,湖北省天门市第一人民医院普外科
  • 收稿日期:2023-04-07 出版日期:2024-06-26
  • 通信作者: 宋劲松

Clinical study of laparoscopic splenectomy by tunnel method

Peng Wu1, Wei Xu1, Zhuang Wang1, Shihai Zheng1, Jinsong Song1,()   

  1. 1. Department of General Surgery, The First Peoples Hospital of Tianmen City, Tianmen Hubei Province 413700, China
  • Received:2023-04-07 Published:2024-06-26
  • Corresponding author: Jinsong Song
引用本文:

吴鹏, 许维, 王壮, 郑世海, 宋劲松. 隧道法行腹腔镜下脾切除术的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(03): 319-322.

Peng Wu, Wei Xu, Zhuang Wang, Shihai Zheng, Jinsong Song. Clinical study of laparoscopic splenectomy by tunnel method[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(03): 319-322.

目的

探讨隧道法行腹腔镜下脾切除术的可行性、安全性及有效性。

方法

回顾性分析同一术者团队在2022年1月至2022年12月期间行腹腔镜下脾切除术48例患者的临床资料,按照离断脾蒂的方式分为A组(隧道法腹腔镜下脾切除术,n=23)和 B组(常规法腹腔镜下脾切除术,n=25)。采用SPSS 22.0统计学软件进行数据分析,围手术期各项指标等计量资料用()表示,组间比较采用独立样本t检验;术后并发症等计数资料组间比较采用χ2检验。P<0.05为差异有统计学意义。

结果

A组患者均顺利完成隧道法腹腔镜下脾切除术,无中转开腹病例;B组患者23例完成常规法腹腔镜下脾切除术,2例中转开腹。手术时间、术后住院时间和术中出血量A组患者少于B组,差异均有统计学意义(P<0.05);两组术后胰瘘、静脉血栓、出血及死亡患者例数比较,差异均无统计学意义(P>0.05)。

结论

隧道法行腹腔镜下脾切除术是可行、安全、有效的。

Objective

To investigate the feasibility, safety and effectiveness of laparoscopic splenectomy by tunnel.

Methods

The clinical data of 48 patients who underwent laparoscopic splenectomy from January 2022 to December 2022 by the same surgical team were retrospectively analyzed and divided into group A (tunnel laparoscopic splenectomy, n=23) and group B (conventional laparoscopic splenectomy, n=25) according to the method of splenic pedicle amputation. SPSS 22.0 statistical software was used for data analysis. Measurement data such as perioperative indicators of patients were represented by (). Independent sample t test was used for comparison between groups. The χ2 test was used to compare the number of postoperative complications among different data groups. P<0.05 was considered statistically significant.

Results

All patients in group A successfully completed the tunnel laparoscopic splenectomy, and no conversion to laparotomy cases. In group B, 23 patients underwent laparoscopic splenectomy and 2 patients underwent laparotomy. Operation time, postoperative hospital stay and intraoperative blood loss in group A were less than those in group B, and the differences were statistically significant (P<0.05). There was no significant difference in the number of postoperative pancreatic fistula, venous thrombosis, hemorrhage and death between the two groups (P>0.05).

Conclusion

Tunnel laparoscopic splenectomy is feasible, safe and effective.

表1 两组患者的一般临床资料比较
图1 金手指建立脾后隧道 图2 丝线结扎脾蒂 图3 离断脾蒂
表2 两组患者围手术期相关指标比较(
表3 两组患者术后并发症和同期行贲周血管离断比较[例(%)]
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