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相關文獻
- Advantages of Laparoscopic Splenectomy for Splenomegaly Due to Hematologic Diseases
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頁籤選單縮合
題名 | Advantages of Laparoscopic Splenectomy for Splenomegaly Due to Hematologic Diseases=腹腔鏡脾臟切除術對血液病所致脾腫處理上之優點 |
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作者 | 袁瑞晃; 陳盛斌; 李威傑; 游憲章; | 書刊名 | 臺灣醫學會雜誌 |
卷期 | 97:7 1998.07[民87.07] |
頁次 | 頁485-489 |
分類號 | 416.24 |
關鍵詞 | 腹腔鏡脾臟切除術; 血液病; 脾腫處理; Laparoscopic splenectomy; Idiopathic thrombocytopenic purpura; β-thalassemia; |
語文 | 英文(English) |
英文摘要 | Recent advancements in laparoscopic surgery have made laparoscopic splenectomy possible. We retrospectively compared the outcomes of laparoscopic versus open splenectomy in patients with idiopathic thrombocytopenic purpura (ITP) or β -thalassemia. From July 1993 to July 1997, 52 patients (ITP, 43 cases; β - thalassemia, 36.9 years ) or conventional open splenectomy (22 patients, 5 men, 17 women; average age, 34.3 years). The two groups were similar in terms of sex, age, diagnosis, duration of disease, preoperative platelet count, and spleen size. The mean surgical time, estimated amount of blood loss, duration of postoperative recovery, analgesic usage, and complications were compared between the two groups. Laparoscopic splenectomy was successful in 29(97%) of the 30 patients. The mean surgical time in the laparoscopy group was longer than in the open splenectomy group (190.6 vs 113.9 minutes, p<0.01). The laparoscopy group had earlier postoperative oral intake (15.2 vs 52.6 hours, P<0.01), less usage of analgesics (meperidine 50mg/unit, 1.1 vs 2.8 units, P<0.01) and a shorter postoperative hospital stay (4.1 vs 6.8 days, p<0.01). The estimated blood loss, incidence of accessory spleen, surgical complication rate, and recurrence rate of thrombocytopenia were similar in the two groups. Our findings show that laparoscopic splenectomy in patients with ITP or β - thalassemia is as safe as the open approach. While laparoscopy required a longer surgical time, the recovery period was shorter, analgesic use was less, and physical discomfort was less severe. |
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