关键词: 腹腔镜, 脾切除术, 标准化程序, 体位改变, 联合入路

Abstract:

Abstract objective To summarize the experience of combined approaches to laparoscopic splenectomy (LS) following a standardized technique by operative position changes. Methods The clinical data of 47 patients who underwent LS in Anqing Hospital from Jul. 2014 to Jun. 2017, were retrospectively analyzed. The LS was performed by adjusting the patients' operative position twice, thus realizing a combined approach, as well as by using a standardized 3-step technique. Results Forty-six patients performed LS successfully, with only one patient having an additional small incision to complete the operation. Operation duration was (91.49±11.96) min. Intraoperative bleeding was (279.89±102.44) mL and no uncontrollable bleeding was found. The postoperative time of anus aerofluxus was (2.13±0.21) d. The duration of postoperative indwelling drainage catheter was (4.77±1.52) d. No pancreatic leakage or intra-abdominal hemorrhage was found, and only reactive pleural effusion was reported in 7 cases. Postoperative hospitalization length was (7.79±1.28) d. No death was found in all patients during follow-up (1 to 35 months). Conclusion The combined approach for programmed LS has high success rate, low incidence of postsurgical complications, and short recovery time. It is a convenient and effective procedure that can be further expanded, especially in basic-level hospital.

Key words: laparoscopy, splenectomy, standardized procedure, position change, combined approach