CAJ | 학술논문

目的：探讨腹腔镜脾脏切除术（ laparoscopic splenectomy ，LS）治疗继发性脾功能亢进的安全性、有效性。方法2001年7月～2012年6月行LS治疗50例继发性脾功能亢进。经脐孔穿刺建立气腹，腔内直线型切割吻合器（ Endo-GIA）离断脾蒂。结果顺利完成50例LS，无一例中转开腹手术。6例发现副脾，术中切除。平均手术时间150 min （70～270 min），平均出血量100 ml（50～200 ml）。术后48 h后血小板平均上升250×109／L（200×109／L～350×109／L）。术后住院3～7 d，平均5 d。1例术后12 h因脾窝积血再次腹腔镜探查，清除积血。1例术后出现急性胰腺炎，经治疗痊愈。50例术后随访24～60个月，平均36个月，脾功能亢进无复发。结论 LS治疗继发性脾功能亢进安全、有效。
목적：탐토복강경비장절제술（ laparoscopic splenectomy ，LS）치료계발성비공능항진적안전성、유효성。방법2001년7월～2012년6월행LS치료50례계발성비공능항진。경제공천자건립기복，강내직선형절할문합기（ Endo-GIA）리단비체。결과순리완성50례LS，무일례중전개복수술。6례발현부비，술중절제。평균수술시간150 min （70～270 min），평균출혈량100 ml（50～200 ml）。술후48 h후혈소판평균상승250×109／L（200×109／L～350×109／L）。술후주원3～7 d，평균5 d。1례술후12 h인비와적혈재차복강경탐사，청제적혈。1례술후출현급성이선염，경치료전유。50례술후수방24～60개월，평균36개월，비공능항진무복발。결론 LS치료계발성비공능항진안전、유효。
Objective To evaluate the safety and efficacy of laparoscopic splenectomy ( LS) for secondary hyperplenism . Methods From July 2001 to June 2012, 50 patients were diagnosed as having secondary hypersplenism and received LS in our hospital.During the operation , pneumoperitoneum was established with a 10 mm trocar through the inferior umblical fold , and then the splenic pedicle was cut off by using an Endo-GIA. Results All the 50 operations of LS were completed within 70-270 min (mean, 150 min) , without conversions to open surgery .An accessory spleen was found in 6 cases and was removed during the operation .The intraoperative blood loss was 50-200 ml (mean, 100 ml).The mean platelet levels increased by 250 ×109/L (200 ×109/L-350 × 109/L) in 48 hours after surgery.The mean hospital stay was 5 days (range, 3 -7 days).One patient received a reoperation of laparoscopic exploration to clear spleen fossa hematocele in 12 hours after surgery .Acute pancreatitis occurred in 1 case, which was cured after medical treatment.All the patients were followed up for 24 -60 months(mean,36 months),and none of them had hypersplenism recurrence . Conclusion Laparoscopic splenectomy is safe and effective for secondary hypersplenism .