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題 名 | Laparoscopic Splenectomy: Preliminary Results and Comparison with Conventional Splenectomy=腹腔鏡脾臟摘除術:早期報告 |
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作 者 | 吳鴻昇; 曾旭弘; 許俊傑; 吳誠中; 劉自嘉; 吳天成; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 33:2 民89.03-04 |
頁 次 | 頁53-58 |
分類號 | 416.24 |
關鍵詞 | 腹腔鏡脾臟摘除術; Laparoscopic splenectomy; Immune thrombocytopenic purpura; |
語 文 | 英文(English) |
中文摘要 | 以脾臟摘除術來治療一些血液病變的病人,有其重要的角色。腹腔鏡脾臟摘除術屬於高級的腹腔鏡手術,因為有一些困難的步驟需要解決:(1)持住一個血管豐富的實質器官;(2)脾臟門部出血;(3)拿出脾臟。然而超音波刀、內視鏡血管夾及內視鏡袋子似乎可以解決這些問題。本院連續有7位病人接受同一外科小組施行腹腔鏡脾臟摘除術。我們以傳統開放式脾臟摘除術與腹腔鏡脾臟摘除術的病人分成兩組進行比對包括性別、年齡、診斷及脾臟重量。數據收集包含手術時間、失血量、進食時間、併發症、術後住院天數、術前及術後輸血量、脾臟重量及住院花費及回到工作崗位的時間等。 腹腔鏡脾臟摘除術平均時間為3.8+0.9小時,比開放式脾臟摘除術為1.8+0.2小時(p=0.002),腹腔鏡脾臟摘除術後平均住院為4.2+0.8天,比開放式脾臟摘除術者為7+0.8天(p=0.02)。而回到工作崗位,腹腔鏡脾臟摘除術為6.8+0.4天,比開放式脾臟摘除術為22.8+4.0天(p=0.0l),兩組在失血量、進食時間、併發症、輸血量及住院花費等並沒有統計上差別。兩組各有一名病人術後效果反應不佳。 兩組比較的結果,腹腔鏡脾臟摘除手術時間比開放式脾臟摘除長,但是住院天數比較短,而且以腹腔鏡脾臟摘除者可以早日回到工作崗位。 |
英文摘要 | 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. |
本系統中英文摘要資訊取自各篇刊載內容。