Volume 44 Issue 9
Sep.  2023
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Guosong LI, Dahua LI, Guojie SONG, Chen YANG, Jiayun GE, Guohui SHAO. The Application Value of Laparoscopic Splenectomy in Traumatic Splenectomy[J]. Journal of Kunming Medical University, 2023, 44(9): 86-92. doi: 10.12259/j.issn.2095-610X.S20230902
Citation: Guosong LI, Dahua LI, Guojie SONG, Chen YANG, Jiayun GE, Guohui SHAO. The Application Value of Laparoscopic Splenectomy in Traumatic Splenectomy[J]. Journal of Kunming Medical University, 2023, 44(9): 86-92. doi: 10.12259/j.issn.2095-610X.S20230902

The Application Value of Laparoscopic Splenectomy in Traumatic Splenectomy

doi: 10.12259/j.issn.2095-610X.S20230902
  • Received Date: 2023-06-17
    Available Online: 2023-09-23
  • Publish Date: 2023-09-30
  •   Objective  To investigate the advantages and disadvantages of laparoscopic splenectomy in patients with splenic rupture, which is very common in surgical practice.   Methods  The data of 61 patients with traumatic splenic rupture admitted to the Second People’s Hospital of Baoshan from May 2012 to October 2022 were retrospectively analyzed. Among the collected data, 25 patients underwent laparoscopic splenectomy and were included in the observation group. Thirty-six patients underwent open surgery (OS) and were included in the control group. The orientation score was matched in 1∶1 ratio, and finally LS and OS were included in 25 cases each. In the observation group (LS group), there were 16 males and 9 females, aged (43.92±21.24) years old, ranging from 16 to 75 years old. In the control group (OS group), there were 19 male patients and 6 female patients, aged (35.20±16.28) years old, ranging from 14 to 65 years old. The indexes (blood loss, postoperative analgesic time, operation time, etc.), hospitalization cost and postoperative complications were compared between the two groups during the whole operation period.   Results  The baseline data of the two groups met the requirement of comparability after the propensity bisection. The operation time of LS group was (157.16±43.47) min, abdominal fluid was 98.00 (50.00, 100.00) mL, intraoperative blood loss was 800.00 (500.00, 1000.00) mL, intraoperative blood transfusion was 450.00 (400.00, 601.25) mL. The first postoperative exhaust was (40.32±13.36) h. The first time of getting out of bed after the operation was 48.00 (48.00, 72.00) h, drainage tube removal time was (72.96±21.33) h, and the postoperative analgesia time was 24.00 (24.00, 48.00) h. The hospital stay was 12.00 (10.00, 14.00) d, which was better than the operating time (184.20±63.14) min, with the effusion volume being 100.00 (100.00, 200.00) mL, intraoperative bleeding volume being 1000.00 (800.00, 1750.00) mL, intraoperative blood transfusion beting 1200.00 (461.00, 1200.00) mL. The first postoperative exhaust (58.56±18.43) h, first postoperative time of getting out of bed 72.00 (48.00, 120.00) h, drainage tube removal time was (102.72±43.00) h , the postoperative analgesia time was 48.00 (36.00, 96.00) h, and the hospital stay time 14 (11.50, 17.00) d was statistically significant (all P < 0.05). The hospitalization cost of LS group was 21800 yuan (1.68, 25800 yuan), slightly higher than that of OS groupof 17 700 yuan (15 100, 21 800 yuan), but the overall difference was not significant.   Conclusion  LS has the advantages over OS in terms of operation time, intraoperative blood loss control, intraoperative blood transfusion amount, postoperative exhaust, postoperative getting out of bed time, analgesic drug use time, abdominal effusion, postoperative complications, etc. It is more conducive to the recovery of patients and the improvement of the prognosis and survival quality, and more in line with the development of modern medicine.
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