Impact of obesity on hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization
10.3760/cma.j.issn.1007-8118.2016.12.008
- VernacularTitle:肥胖对手助腹腔镜脾切除联合贲门周围血管离断术的影响
- Author:
Chuan PANG
;
Zhiwei LI
- Keywords:
Obesity;
Hand-assisted laparoscopic splenectomy;
Devascularization;
Massive splenomegaly;
Perioperative period
- From:
Chinese Journal of Hepatobiliary Surgery
2016;22(12):822-826
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the impact of obesity on the perioperative outcomes of hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization (LSED).Methods The clinical data of patients who underwent hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization between Jan.2013 and Nov.2015 were retrospectively analyzed.The patients were classified as obese group A (BMI≥28 kg/m2) or non-obese group B (BMI ＜ 28 kg/m2).Group A was further divided into two subgroups:group A1 massive splenomegaly (diameter ＞ 20 cm) and A2 splenomegaly (diameter ≤20 cm).The conversion rates,operative complications,mortality,length of stay,operative time,and blood loss were analyzed and compared.Results One hundred and sixty patients who underwent hand-assisted LSED were included into this study.54 patients were in group A and 106 in group B.A significantly longer operative time was found in group A (291 min vs.261 min,P ＜ 0.05).The conversion rates,blood loss,length of hospital stay,overall morbidity rates,and mortality rates were similar in the two groups (P ＞0.05).The mean operative time was significantly longer in group A1 (336 min vs.270 min;P ＜0.01)although blood loss,conversion rates,and overall morbidity rates were higher in group A1.However,there were no significant differences (P ＞ 0.05).Conclusions Hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization for obese patients was safe and feasible.However,for patients with massive splenomegaly,LSED should be performed with caution.
