Wang Jianyao,Lao Jing,Wang Huansheng,et al.Clinical analysis of laparoscopic splenectomy for hypersplenism caused by hematologic diseases in children[J].Journal of Clinical Pediatric Surgery,,21():617-621.[doi:10.3760/cma.j.cn101785-202104053-004]
Clinical analysis of laparoscopic splenectomy for hypersplenism caused by hematologic diseases in children
- Keywords:
- Splenectomy/MT; Laparoscopy; Hypersplenism/SU; Treatment Outcome; Child
- Abstract:
- Objective To explore the advantages, feasibility and safety of linear cutting closure device during laparoscopic splenectomy for hypersplenism caused by hematologic diseases in children.Methods From January 2016 to April 2021, 32 children with hypersplenism caused by hematological diseases underwent laparoscopic splenectomy.There were 13 boys and 19 girls with an age range of 5 to 16 years.The causes were thalassemia (n=28) and hereditary spherocytosis (n=4).The procedures included traditional laparoscopic splenectomy with bundle ligation of splenic pedicle (n=18) and laparoscopic splenectomy in situ (n=14).The perioperative status and postoperative complications of two groups were compared.Results Two cases of hereditary spherocytosis complicated with acute obstruction of common bile duct improved through fasting, gastrointestinal decompression and acid and enzyme inhibition.And splenectomy was performed 1 month later.The remainders were successfully operated without any conversion into open surgery.Postoperative hospital stay was significantly shorter in laparoscopic in situ splenectomy group (P<0.05).Postoperative anal exhaust defecation time, postoperative eating time and postoperative antibiotic use time were basically similar in two groups and the differences were not statistically significant (P>0.05);laparoscopic in situ splenectomy group had shorter operative duration and lesser intraoperative blood loss.And the difference was statistically significant (P>0.05).In traditional laparoscopic group, two children received intraoperative infusion of 0.5 unit of red blood cell suspension.There was no severe fulminant infection.In traditional laparoscopic group, one child of portal vein thrombosis became relieved after thrombolytic therapy.Conclusion For pediatric hematological diseases, laparoscopic in situ splenectomy offers the advantages of simple handling, shorter operative duration, minimal trauma, less bleeding, faster postoperative recovery, fewer postoperative complications and shorter hospitalization stay.
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Memo
收稿日期:2021-04-23。
基金项目:广东省医学科研基金（A2020629）；深圳市医疗卫生三名工程项目（SZSM201812055）；深圳市医学重点学科建设基金（SZXK035）
通讯作者:王斌,Email:szwb1967@126.com