| 摘要 |
Splenectomy plays an important role in the management of selected patients with hematologic disorders. Splenectomy via the laparoscopic route is an advanced procedure with several difficulties: (1) handling of a hypervascular solid organ: (2) bleeding (hilum) and (3) removal of the spleen. The purpose of this study was to evaluate our initial experience with laparoscopic splenectomy (LS) and compare it with our experience in open splenectomy (OS). Seven consecutive patients who underwent LS were reviewed. For comparison, a control group of 5 patients, undergoing open splenectomy, matched for sex, age, diagnosis and splenic weight during the same period was included. Data including operative time, blood loss, tolerance to liquids, complications, postoperative hospital stay, preoperative and postoperative hemoglobin and platelet counts, blood and platelet transfusions, splenic weight and hospital costs were collected. Operative time averaged 3.8+-0.9 hours for LS and 1.8+-0.2 hours for OS (p=0.002). In the LS group, the mean postoperative hospital stay was 4.2+-0.8 days, compared with 7 +-0.8 days for the OS group (p=0.02), and return to work for LS was 6.8+-0.4 days, compared with 22.8+-4.0 days for OS (p=0.01). No differences were observed in blood loss, tolerance to liquids, complication rates, transfusion requirements or hospital costs. LS requires a longer operative time than OS. However, LS leads to a shorter hospital stay and earlier return to work. |
