Laparoscopic splenectomy. Technique and results in a series of 27 cases.

作者: Peiper M , Emmermann A , Broelsch Ce , Zornig C , Weh Hj

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摘要: Between early 1992 and December 1994, laparoscopic splenectomy was performed in 27 patients with idiopathic thrombocytopenia (ITP), hairy-cell leucemia, HIV, or Hodgkin's disease. In all cases medical treatment, especially cortisone therapy, failed. disease the combined liver biopsies dissection of parailiacal, paraaortic, mesenteric lymph nodes for abdominal staging. The operation using four trocars; splenic vessels were divided by a linear stapler. general spleen removed bag through slightly enlarged trocar incision after morcellation. Three needed small laparotomy removal (laparoscopic assisted). recent case intact via posterior colpotomy. 22 (81%) finished laparoscopically. Five times conversion to conventional necessary because bleeding at hilum. Wound infections occurred two cases. one patient ITP platelet count did not improve continuous blood loss led relaparotomy 1st postoperative day. No surgical found. All tolerated fluid diet day hospitalization time 4.4 days (range 3-14). Regarding low complication rate advantages smaller trauma period, approach elective staging has substantial benefit patients.

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