Hand-Assisted Laparoscopic Splenectomy with Temporary Splenic Artery Occlusion in Pediatric Patients: The Experience in a Chinese Tertiary Children's Hospital

作者全名："Zhang, Rensen; Yan, Chengwei; Kang, Cailong; Chen, Bailin; Guo, Chunbao"

作者地址："[Zhang, Rensen; Kang, Cailong; Chen, Bailin; Guo, Chunbao] Chongqing Med Univ, Childrens Hosp, Dept Pediat Gen Surg, Chongqing, Peoples R China; [Zhang, Rensen; Kang, Cailong; Chen, Bailin; Guo, Chunbao] Minist Educ Key Lab Child Dev & Disorders, Chongqing, Peoples R China; [Zhang, Rensen; Kang, Cailong; Chen, Bailin; Guo, Chunbao] Chongqing Med Univ, Childrens Hosp, Chongqing, Peoples R China; [Zhang, Rensen; Kang, Cailong; Chen, Bailin; Guo, Chunbao] Natl Clin Res Ctr Child Hlth & Disorders Chongqing, Chongqing, Peoples R China; [Zhang, Rensen; Kang, Cailong; Chen, Bailin; Guo, Chunbao] China Int Sci & Technol Cooperat base Child Dev &, Chongqing, Peoples R China; [Zhang, Rensen; Kang, Cailong; Chen, Bailin; Guo, Chunbao] Chongqing Med Univ, Chongqing Key Lab Pediat, Childrens Hosp, Chongqing, Peoples R China; [Zhang, Rensen; Kang, Cailong; Chen, Bailin; Guo, Chunbao] Chongqing Med Univ, Chongqing Womens & Childrens Hosp, Dept Pediat Surg, Chongqing, Peoples R China; [Yan, Chengwei] Chongqing Univ, Dept Pediat Gen Surg, Three Gorges Hosp, Chongqing, Peoples R China; [Guo, Chunbao] Chongqing Med Univ, Chongqing Womens & Childrens Hosp, Dept Pediat Surg, 136 Zhongshan 2nd Rd, Chongqing 400014, Peoples R China"

通信作者："Guo, CB (通讯作者)，Chongqing Med Univ, Chongqing Womens & Childrens Hosp, Dept Pediat Surg, 136 Zhongshan 2nd Rd, Chongqing 400014, Peoples R China."

来源：JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000800344500001

JCR分区：Q3

影响因子：1.3

年份：2022

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期号：　

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文献类型：Article; Early Access

关键词：hand-assisted laparoscopic splenectomy; partial splenectomy; open surgery

摘要："Background: The hand-assisted laparoscopic splenectomy (HALS) approach overcomes the difficulties experienced with conventional laparoscopic splenectomy (LS) with added advantages. In this study, we compared the HALS technique with standard LS based on the feasibility and intermediate postoperative outcomes in pediatric patients.Methods: We retrospectively investigated pediatric patients who underwent HALS or LS from October 2013 to May 2021 at the Children's Hospital, Chongqing Medical University. Potential parameters related to HALS or LS were explored, and the intermediate-term clinical outcomes were compared between the two groups. The quality of life and splenic regrowth data were followed up routinely for 12 months after the operation.Results: In total, 39 patients underwent splenectomy (11 for HALS and 28 for LS) and were eligible for this research. Patients who underwent HALS had a greater proportion of focal benign splenic lesions (P < .001) and partial splenectomy (P < .001). The HALS operative time was reduced compared with LS (P = .032). No operation conversion was noted in the HALS group, whereas 4 (14.3%) cases were converted to an open operation (P = .249). For partial splenectomies, favorable outcomes with HALS, including short operative time (P = .001) and reduced blood loss (P = .014), were noted compared with LS. No postoperative mortality was observed. During the follow-up period, a good quality of life and splenic regrowth were noted for most of the patients.Conclusions: Although another incision is necessary, HALS confers the advantages of a minimally invasive technique to manage the fragile spleen, especially in pediatric patients requiring partial splenectomy."

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