旋切器在腹腔镜下脾切除术中的应用体会

Application of rotary cutter during laparoscopic splenectomy

摘要:

目的??探讨外伤性脾破裂在腹腔镜下脾切除术中应用旋切器进行取脾的可行性及临床价值。方法?回顾性分析该院2014年6月-2016年6月因外伤性脾破裂行腹腔镜脾切除术的10例患者的临床资料。结果?其中9例患者在旋切器配合下完成手术，1例因难以控制的出血中转开腹，旋切器配合腹腔镜脾切除术组中手术时间95～170 min，术中出血量300～800 ml，自体血回输400～1 200 ml，术后住院天数8～14 d，术后随访3～24个月无严重相关并发症发生。结论?在旋切器配合下行腹腔镜脾切除术安全可行，无需大范围扩大腹壁切口，具有创伤较小、恢复快等的特点，多适用于外伤及良性脾脏病变而需行脾切除的病例，值得临床推广与应用。

Abstract:

Objective?To explore the feasibility and clinical effects of rotary cutter in laparoscopic splenectomy in treatment of traumatic spleen rupture.?Methods?The study retrospectively identified 10 cases with traumatic spleen rupture treated with laparoscopic splenectomy from June 2014 to June 2016.?Results?Total laparoscopic splenectomy combined with rotary cutter was completed successfully in 9 cases and 1 case was converted to open laparotomy due to intraoperative uncontrollable hemorrhage. The former operative time was 95 ~ 170 min, the estimated intraoperative amount of blood loss was 300 ~ 800 ml and autologous blood transfusion of 400 ~ 1 200 ml was conducted. The postoperative hospital stay was 8 ~ 14 d. No serious complications were found in the cases followed-up for 3 ~ 24 months after operation.?Conclusion?Laparoscopic splenectomy combined with rotary cutter is not only feasible and safe but also has the merits of minimally invasive surgery. It can be applied in treating those with abdominal trauma and with benign lesions in spleen. So it deserved promotion and application in clinical work.