Objective To comparatively study the application of spleen subpedicle severance ( SSS )method and Endo-GIA method in laparoscopic splenectomy( LC ), and to evaluate the feasibility of LS. Methods The clinical data of 40 LS cases in our hospital from January 2002 to October 2011 were retrospectively analyzed. Endo-GIA was used on 14 cases and SSS was used on 24 cases. Results In all cases receiving primary surgery,38 successfully completed LS,and 2( 5% )were changed to laparotomy due to intraoperative bleeding. Two different methods were applied to dissect the splenic pedicle. Drainage time and postoperative hospitalization time in SSS group were longer than Endo-GIA group( P<0.05 ),and Endo-GIA group costed significantly higher( P < 0. 05 ). Differences in operation time, intraoperative blood loss, time to start postoperative feeding, and drainage volume on day 1 were not statistically significant P < 0.05 ). Conclusion Anatomical SSS can replace the use of Endo-GIA. This contributes to the rational use of health resources,reduced health care costs,and relieved personal burden economically and psychologically, thus worth a wider application nationwide.%目的 对比研究二级脾蒂离断法与内镜下切割吻合器(Endo-GIA)法在腹腔镜脾切除术中的应用,以评价腹腔镜脾切除术在临床推广应用的可行性.方法 2002年1月至2011年10月间腹腔镜脾切除术40例,其中14例采用Endo-GIA法,24例采用二级脾蒂离断法.结果 40例腹腔镜脾切除术中有2例因术中出血难止、手术视野模糊而中转开腹,中转开腹率为5%,并且均为初次开展手术者.使用二级脾蒂离断法的患者留置引流时间、术后住院时间长于Endo-GIA法(P＜0.05),而住院费用明显低于Endo-GIA法(P＜0.05).两组手术时间、术中失血量、术后进食时间、第一天引流量比较,差异均无统计学意义(P>0.05).结论 采用解剖二级脾蒂离断法,免除了Endo-GIA的使用,该法有助于合理应用卫生资源,降低医疗成本,减轻患者经济和心理负担.
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