• 第三軍醫(yī)大學(xué)新橋醫(yī)院肝膽外科（重慶 400037）;

【摘要】目的 探討腹腔鏡脾切除術(shù)（laparoscopic splenectomy,LS)的手術(shù)方法、安全性及臨床效果。 方法 對(duì)當(dāng)前國內(nèi)、外有關(guān)腹腔鏡脾切除的研究報(bào)道及最新進(jìn)展進(jìn)行綜述和分析。 結(jié)果 隨著技術(shù)的進(jìn)步，LS的適應(yīng)證逐漸擴(kuò)大；脾臟大小是影響LS手術(shù)效果的重要因素。

結(jié)論 LS具有微創(chuàng)外科的一切優(yōu)點(diǎn)。對(duì)于巨大脾臟，選擇手助的LS是安全可行的，且比開腹手術(shù)具有優(yōu)越性。隨著手術(shù)者經(jīng)驗(yàn)的積累及手術(shù)方法、操作器械的不斷改進(jìn)，LS將越來越廣泛地被應(yīng)用于臨床。

引用本文： 鄭璐,李靖,梁平. 腹腔鏡脾切除術(shù)的研究進(jìn)展. 中國普外基礎(chǔ)與臨床雜志, 2005, 12(6): 574-576. doi: 復(fù)制

1. 1 Rhodes M, Rudd M, O ’Rourke N, et al. Ann Surg, 1995; 222(1)432 許紅兵，蕭蔭祺，李為民，等. 電視腹腔鏡脾切除一例報(bào)告 [J]. 內(nèi)鏡外科雜志， 1994； 1（增刊）2933 王先法，蔡秀軍，虞洪，等. 腹腔鏡脾切除41例臨床分析 [J]. 中華普通外科雜志， 2003； 18（10）6074 Brodsky JA, Brody FJ, Walsh RM, et al. Laparoscopic splenectomy [J]. Surg Endosc, 2002; 16(5)8515 朱江帆，陳江，張華云，等. 手助腹腔鏡脾切除術(shù) [J]. 中國微創(chuàng)外科雜志， 2002； 10（2）486 Borrazzo EC, Daly JM, Morrisey KP, et al. Handassisted laparoscopic splenectomy for giant spleens [J]. Surg Endosc, 2003; 17(6)917 許紅兵，蕭蔭祺，鄭方，等. 套袖與免氣腹裝置輔助腹腔鏡巨脾切除及斷流術(shù) [J]. 中華消化內(nèi)鏡雜志， 1997； 14（2）1308 周漢新. 微創(chuàng)外科的明天——機(jī)器人手術(shù) [J]. 中國普通外科雜志， 2003； 12（12）8819 Chapman WH 3rd, Albrecht RJ, Kim VB, et al. Computerassisted laparoscopic splenectomy with the da Vinci surgical robot [J]. J Laparoendosc Adv Surg Tech A, 2002; 12(3)15510 Rechardson WJ. Introduce a new method for laparoscopic splenectomy [J]. J Am Coll Surg, 2003; 185(10)41211 Tan M, Zheng CX, Wu ZM, et al. Laparoscopic splenectomy: the latest technical evaluation [J]. World J Gastroenterol, 2003; 9(5)108612 Chan SW, Hensman C, Waxman BP, et al. Technical developments and a team approach leads to an improved outcome: lessons learnt implementing laparoscopic splenectomy [J]. ANZ J Surg, 2002; 72(7)52313 Ng WT, Lee KW. Control of hemorrhage during laparoscopic splenectomy [J]. Surgery, 2001; 129(5)65214 Yano H, Iwazawa T, Kinuta M, et al. Solitary splenic metastasis from ovarian cancer successfully treated by handassisted laparoscopic splenectomy: report of a case [J]. Surg Today, 2002; (8)75015 Allran CF Jr, Weiss CA 3rd, Park AE. Urgent laparoscopic splenectomy in a morbidly obese pregnant woman: case report and literature review [J]. J Laparoendosc Adv Surg Tech A, 2002; 12(6)44516 Ailawadi G, Yahanda A, Dimick JB, et al. Handassisted laparoscopic splenectomy in patients with splenomegaly or prior upper abdominal operation [J]. Surgery, 2002; 132(4)68917 Cordera F, Long KH, Nagorney DM, et al. Open versus laparoscopic splenectomy for idiopathic thrombocytopenic purpura: clinical and economic analysis [J]. Surgery, 2003; 134(1)4518 Patel AG, Parker JE, Wallwork B, et al. Massive splenomegaly is associated with significant morbidity after laparoscopic splenectomy [J]. Ann Surg, 2003; 238(2)23519 馮澤榮，賀孝文，廖軻. 手助腹腔鏡與開腹脾切除加門奇靜脈阻斷術(shù)的前瞻性對(duì)比研究 [J]. 腹腔鏡外科雜志， 2003； 8（4）224.
  1. 1. 1 Rhodes M, Rudd M, O ’Rourke N, et al. Ann Surg, 1995; 222(1)432 許紅兵，蕭蔭祺，李為民，等. 電視腹腔鏡脾切除一例報(bào)告 [J]. 內(nèi)鏡外科雜志， 1994； 1（增刊）2933 王先法，蔡秀軍，虞洪，等. 腹腔鏡脾切除41例臨床分析 [J]. 中華普通外科雜志， 2003； 18（10）6074 Brodsky JA, Brody FJ, Walsh RM, et al. Laparoscopic splenectomy [J]. Surg Endosc, 2002; 16(5)8515 朱江帆，陳江，張華云，等. 手助腹腔鏡脾切除術(shù) [J]. 中國微創(chuàng)外科雜志， 2002； 10（2）486 Borrazzo EC, Daly JM, Morrisey KP, et al. Handassisted laparoscopic splenectomy for giant spleens [J]. Surg Endosc, 2003; 17(6)917 許紅兵，蕭蔭祺，鄭方，等. 套袖與免氣腹裝置輔助腹腔鏡巨脾切除及斷流術(shù) [J]. 中華消化內(nèi)鏡雜志， 1997； 14（2）1308 周漢新. 微創(chuàng)外科的明天——機(jī)器人手術(shù) [J]. 中國普通外科雜志， 2003； 12（12）8819 Chapman WH 3rd, Albrecht RJ, Kim VB, et al. Computerassisted laparoscopic splenectomy with the da Vinci surgical robot [J]. J Laparoendosc Adv Surg Tech A, 2002; 12(3)15510 Rechardson WJ. Introduce a new method for laparoscopic splenectomy [J]. J Am Coll Surg, 2003; 185(10)41211 Tan M, Zheng CX, Wu ZM, et al. Laparoscopic splenectomy: the latest technical evaluation [J]. World J Gastroenterol, 2003; 9(5)108612 Chan SW, Hensman C, Waxman BP, et al. Technical developments and a team approach leads to an improved outcome: lessons learnt implementing laparoscopic splenectomy [J]. ANZ J Surg, 2002; 72(7)52313 Ng WT, Lee KW. Control of hemorrhage during laparoscopic splenectomy [J]. Surgery, 2001; 129(5)65214 Yano H, Iwazawa T, Kinuta M, et al. Solitary splenic metastasis from ovarian cancer successfully treated by handassisted laparoscopic splenectomy: report of a case [J]. Surg Today, 2002; (8)75015 Allran CF Jr, Weiss CA 3rd, Park AE. Urgent laparoscopic splenectomy in a morbidly obese pregnant woman: case report and literature review [J]. J Laparoendosc Adv Surg Tech A, 2002; 12(6)44516 Ailawadi G, Yahanda A, Dimick JB, et al. Handassisted laparoscopic splenectomy in patients with splenomegaly or prior upper abdominal operation [J]. Surgery, 2002; 132(4)68917 Cordera F, Long KH, Nagorney DM, et al. Open versus laparoscopic splenectomy for idiopathic thrombocytopenic purpura: clinical and economic analysis [J]. Surgery, 2003; 134(1)4518 Patel AG, Parker JE, Wallwork B, et al. Massive splenomegaly is associated with significant morbidity after laparoscopic splenectomy [J]. Ann Surg, 2003; 238(2)23519 馮澤榮，賀孝文，廖軻. 手助腹腔鏡與開腹脾切除加門奇靜脈阻斷術(shù)的前瞻性對(duì)比研究 [J]. 腹腔鏡外科雜志， 2003； 8（4）224.