摘要
目的对比分析经脐单孔腹腔镜脾脏切除术与传统多孔腹腔镜脾脏切除术的安全性及临床应用效果。方法回顾性分析2010年12月至今开展的18例经脐单孔腹腔镜脾脏切除术患者的临床资料(观察组)及同期行传统五孔法腹腔镜脾脏切除术的43例患者的临床资料(对照组)。对两组手术时间、术中出血量、并发症发生率、术后住院时间及术后疼痛评分进行比较分析。结果两组均在原定术式下顺利完成手术,术后经相关治疗均顺利康复出院,均未出现围术期严重并发症。观察组手术时间长于对照组,差异有统计学意义(P<0.05)。两组术中出血量、术后并发症发生率比较,差异无统计学意义(P>0.05)。观察组术后第1天疼痛评分低于对照组,观察组术后住院时间短于对照组,差异均有统计学意义(P<0.05)。结论对于积累有一定腹腔镜手术经验的单位开展经脐单孔腹腔镜脾脏切除术是安全、可行的,尤其对于脾脏大小正常或轻中度肿大的非肥胖患者。经脐单孔腹腔镜脾脏切除术较传统多孔腹腔镜脾脏切除术创伤更小,具有更好的美容效果,能够进一步减轻患者术后疼痛感,缩短术后住院时间,拥有广阔的应用前景。
Objective To compare the safety and clinical efficacy between transumbilical single port laparoscopic splenectomy and conventional multiport laparoseopie splenectomy. Methods The clinical data of 18 patients（ observation group） undergoing transumbilical single port laparoscopic splenectomy and 43 patients （control group） undergoing conventional five-port laparoscopic splenectomy during the same period were retrospectively analyzed. The operative duration, intraoperative blood loss, the incidence of complications, postoperative hospital stay and postoperative pain scores were compared between the two groups. Results The operation was completed successfully in both groups without changing the surgical plans. All the patients were discharged after postoperative relevant therapy, and no serious perioperative complications occurred. The operative duration of the observation group was longer than that of the control group （ P 〈 0.05 ）. There were no significant differences in intraoperative blood loss, the incidence rate of postoperative complications between the two groups （P 〉 0.05 ）. The pain score at the first day after operation was lower and the postoperative hospital stay was shorter in the observation group compared to the control group （P 〈 0.05 ）. Conclusion In the institutions with some experience of laparoscopic surgel~~, it is safe and feasible to conduct transumbilical single port laparoseopic splenectomy especially for non obese patients with normal size or mild enlargement of spleen. Compared to conventional multiport laparoscopic splenectomy, transumbilical single port laparoscopic spleneetomy is less traumatic, can achieve better cosmetic effect, further alleviate postoperative pain and shorten postoperative hospital stay. This approach obtains broad prospect of application.
出处
《微创医学》
2018年第1期48-51,88,共5页
Journal of Minimally Invasive Medicine
基金
广西科学研究与技术开发计划项目(编号:桂科攻1598011-1)
关键词
经脐
单孔腹腔镜
脾切除术
对照研究
Transumbilical
Single port laparoscope
Splenectomy
Control study
