腹腔镜脾切除加食管贲门周围血管断流术与开腹手术的临床比较及对机体免疫功能的影响研究-外科学专业论文.docxVIP

广州医学院硕士学位论文腹腔镜脾切除加食管贲门周围血管断流术与开腹手术的临床比较和对机体免疫功能的影响研究 广州医学院硕士学位论文 腹腔镜脾切除加食管贲门周围血管断流术与开腹手术的临床比较和对机体免疫功能的影响研究 PAGE PAGE 5 splenectomy ( LS) performed successfully in the Royal Hospital of Australia Lisbon in 1991. In China, the fist case was reported in 309 Hospital in 1994. Nowadays laparoscopic splenectomy with periesophagogastric devascularization has been increasingly used in many hospitals in our country. Due to the establishment of pneumoperitoneum and the difficulty of the operation, Sometimes ,we need to take a 5cm incision to complete the operation .It is still need to study the real difference in trauma ,recovery and immune system response between laparoscopic surgery and laparotomy and more research about laparoscopic surgery. Objective: To investigate the clinical effect between laparoscopic splenectomy with periesophagogastric devascularization and open surgery on immune system and wound response , provide a guide for clinic treatment. Methods: Collect the clinical data of 60 patients who have diagnosed with liver cirrhosis, portal hypertension and esophageal varices and needed surgery from 2007 to 2010 in our hospital . The patients were divided into open surgery group and laparoscopic surgery group, with 30 cases in each group. In LS group ,16cases were performed by hand-assisted laparoscopic surgery,14cases were performed by total laparoscopic surgery. Some clinic date were analyzed comparatively, such as the large of spleen , postoperative hospitalization, passage of gas by anus, the blood loss and so on .The level and diversity of multiple immunoassays like TNF-α ,CRP,IL-6， were tested and comparatively analyzed in preoperative and postoperative different periods. Results: Compared to open surgery, laparoscopic splenectomy with periesophagogastric devascularization was slightly longer on operative time (p0.05), but declined on postoperative hospitalization, passage of gas by anus and the blood loss(p0.05). It is no significantly difference in posto