RESUMEN
Objective To study the clinical effect of minimally invasive resection of spleen in the upper margin of the spleen pedicle. Methods 152 patients underwent splenectomy were enrolled in this study from June 2012 to June 2017. All patients underwent laparoscopic splenectomy. Among the 118 patients, the spleen pedicle was removed from the spine pedicle of the spleen pedicle and the spleen pedicle was taken as the control group. Comparison of the two groups of patients with perioperative period, 7 d postoperative hematological indicators and complications occurred. Results The intraoperative blood loss (51.85 ± 27.14) ml, the operation time (69.39 ± 19.34) min and the transfer rate (0.84%) were lower in the observation group than those in the control group (82.67 ± 36.29) ml, (119.44 ± 23.73) min and (8.82%), the difference was statistically significant (P < 0.05). There was no significant difference in the time of first anal exhaust, food time and hospitalization time (P > 0.05). The levels of blood white blood cell count (WBC) (4.32 ± 1.14) ×109/L, hemoglobin (Hb) (125.37 ± 18.28) g/L and platelet (PLT) were significantly higher than those in the observation group (378.28±112.94) (P < 0.05) were significantly higher than those in the control group (3.28 ± 1.05) ×109/L, (97.23 ± 22.43) g/L and (239.42 ± 134.82) ×109/L, respectively. The incidence of pancreatic fistula, abdominal hemorrhage, portal vein thrombosis, infection and intestinal obstruction was significantly lower in the observation group than in the control group (P < 0.05). Conclusion Splenectomy of splenic pedicle in spleen splenectomy can reduce the intraoperative blood loss and transfer rate, reduce the operation time and reduce the incidence of postoperative complications. It can be further promoted in clinical and use.
RESUMEN
Objective To summarize our experience on laparoscopic splenectomy with amputation of the secondary spleen pedicle. Methods From September 2006 to May 2007, laparoscopic splenectomy with amputation of the secondary spleen pedicle was performed on 13 patients, including 5 cases of traumatic spleen rupture, 2 idiopathic thrombocytopenic purpura, and 6 hypersplenism. Results All the operations were completed under a laparoscope without using hand-assisted procedures. The intraoperative blood loss was 50-800 ml (mean, 350 ml), and the operation time was 150-300 min (mean, 210 min). No complications occurred during and after the operation. The average postoperative hospital stay was 5-9 d (mean, 7.5 d). The patients were followed up for 1-6 months, during which all the patients had normal platelet count. Conclusions Laparoscopic splenectomy with amputation of the secondary spleen pedicle is a feasible, minimally invasive, safe and low-cost procedure.