The application effect of laparoscopic <i>versus</i> open surgery in treatment of traumatic rupture of spleen: a meta-analysis _CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Lifa ^1,2 , HOU Songlin ² , CHEN Xiaobo ¹ , LIU Daizhi ² , ZHANG Guangjun ¹ , ZHOU He ¹ , ZHANG Jingxiao ³ ,  ZHOU Tong ^1,2

1. The Second Department of Gastrointestinal Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;
2. Institute of Hepatobiliary Pancreas and Intestinal Disease, North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;
3. Internal Medicine Department, The Second Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;

Corresponding?author：

ZHOU Tong, Email: zhoutong0088@163.com

Keywords：

traumatic rupture of spleen; laparoscopy; open surgery; effect; meta-analysis

DOI：

10.7507/1007-9424.201710005

Video：

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Objective To investigate the difference of effect between laparoscopic and open surgery in patients with traumatic rupture of spleen. Methods The literatures on comparison of laparoscopic and open surgery in patients with traumatic rupture of spleen were retrieved in PubMed, Web of Science, CNKI, Wanfang, and VIP databases from Jan. 2007 to Jan. 2017, and then Stata 12.0 software was applied to present meta-analysis. Results ① The condition during operation: compared with the OS group, operative time of the LS group was shorter [SMD=–0.71, 95% CI was (–1.12, –0.30), P=0.001] and intraoperative blood loss of the LS group was less [SMD=–1.53, 95% CI was (–2.28, –0.78), P<0.001]. ② The postoperative condition: compared with the OS group, the postoperative anal exhaust time [SMD=–2.47, 95% CI was (–3.24, –1.70), P<0.001], postoperative ambulation time [SMD=–2.97, 95% CI was (–4.32, –1.62), P<0.001], and hospital stay [SMD=–1.68, 95% CI was (–2.15, –1.21), P<0.001] of the LS group were all shorter. ③ The overall incidence of complications and the incidence of complications: on the one hand, compared with the OS group, patients in the LS group had a lower overall incidence of postoperative complications [OR=0.29, 95% CI was (0.19, 0.43), P<0.001]. On the other hand, compared with the OS group, patients in the LS group had lower incidences of infection [OR=0.27, 95% CI was (0.13, 0.55), P<0.001], ascites [OR=0.36, 95% CI was (0.13, 1.00), P=0.049], bleeding [OR=0.29, 95% CI was (0.10, 0.90), P=0.032], ileus [OR=0.34, 95% CI was (0.13, 0.90), P=0.030], incision fat liquefaction [OR=0.27, 95% CI was (0.08, 0.94), P=0.040], and incision rupture [OR=0.17, 95% CI was (0.03, 0.96), P=0.045]. However, there was no statistical difference on splenectomy fever [OR=0.41, 95% CI was (0.13, 1.27), P=0.123], pancreatic fistula [OR=0.40, 95% CI was (0.06, 2.63), P=0.343], liver function lesion [OR=0.36, 95% CI was (0.10, 1.34), P=0.127], and thrombosis [OR=0.33, 95% CI was (0.09, 1.22), P=0.097] between the 2 groups. Conclusions Laparoscopic surgery can not only significantly reduce the incidence of multiple complications of traumatic rupture of spleen, but also can speed up the recovery rate of postoperative recovery. Therefore, it is safe and beneficial in treatment of patients with traumatic rupture of spleen.

Citation： LI Lifa, HOU Songlin, CHEN Xiaobo, LIU Daizhi, ZHANG Guangjun, ZHOU He, ZHANG Jingxiao, ZHOU Tong. The application effect of laparoscopic versus open surgery in treatment of traumatic rupture of spleen: a meta-analysis . CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(7): 837-845. doi: 10.7507/1007-9424.201710005 Copy

1.	Kohler JE, Chokshi NK. Management of abdominal solid organ injury after blunt trauma. Pediatr Ann, 2016, 45(7): e241-e246.
2.	Soo KM, Lin TY, Chen CW, et al. More becomes less: management strategy has definitely changed over the past decade of splenic injury-a nationwide population-based study. Biomed Res Int, 2015, 2015: 124969.
3.	Li Y, Cui L, Zhang W, et al. Laparoscopic radiofrequency ablation for traumatic splenic rupture. J Surg Res, 2013, 185(2): 711-716.
4.	曾憲濤, 劉慧, 陳曦, 等. Meta 分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
5.	鄭俊杰. 閉合性腹外傷并脾破裂行腹腔鏡與開腹手術的療效對比分析. 內蒙古中醫藥, 2013, 32(14): 87-88.
6.	左超海. 腹腔鏡與開腹脾切除術治療創傷性脾破裂的臨床對比. 中外醫療, 2011, 30(34): 22-23.
7.	王祖高. 腹腔鏡手術治療外傷性脾破裂 36 例的臨床研究體會. 中國醫藥導刊, 2013, 15(12): 2008-2009, 2011.
8.	孫海東, 曹健, 穆霄燕, 等. 應用腹腔鏡治療急性創傷性脾破裂臨床研究. 武警后勤學院學報 (醫學版), 2014, 23(3): 199-201.
9.	史群. 腹腔鏡引導下脾切除術治療外傷性脾破裂效果分析. 中國鄉村醫藥, 2014, 21(24): 10-11.
10.	徐斌勇, 蔣揚, 方興保. 腹腔鏡手術治療脾破裂的臨床分析. 腹腔鏡外科雜志, 2015, 20(2): 119-121.
11.	羅曉峰, 王振龍, 何濤, 等. 外傷性脾破裂腹腔鏡與開腹脾切除臨床研究. 嶺南現代臨床外科, 2015, 15(2): 142-145.
12.	李永雙, 謝強, 楊大業, 等. 腹腔鏡和開腹手術治療外傷性脾破裂臨床效果對比分析. 陜西醫學雜志, 2015, 44(2): 194-196.
13.	阿布來提?阿布都熱西提. 腹腔鏡脾切除術與開腹脾切除術治療外傷性脾破裂的臨床對比. 世界最新醫學信息文摘 (電子版), 2016, 16(18): 119, 122.
14.	劉國生, 藺暉琦, 尹照成, 等. 48 例外傷性脾破裂腹腔鏡脾切除的治療體會. 中國實用醫藥, 2016, 11(2): 6-8.
15.	陳文山, 任虎, 魏天天. 腹腔鏡手術治療外傷性脾破裂的臨床效果研究. 數理醫藥學雜志, 2016, 29(11): 1629-1630.
16.	李國莉. 開腹脾切除與腹腔鏡治療外傷性脾破裂的臨床效果對比. 醫藥前沿, 2016, 6(24): 59-60.
17.	張斌, 彭翔, 王群偉, 等. 腹腔鏡治療閉合性腹外傷合并脾破裂的臨床分析. 吉林醫學, 2016, 37(1): 156-157.
18.	王曉東. 手術治療外傷性脾破裂的臨床療效觀察. 世界最新醫學信息文摘 (電子版), 2016, 1(95): 92, 106.
19.	梁平. 外傷性脾破裂手術治療的療效分析. 臨床醫藥文獻電子雜志, 2016, 3(6): 1018-1019.
20.	Todd SR. Critical concepts in abdominal injury. Crit Care Clin, 2004, 20(1): 119-134.
21.	Abraham RJ, Illyas AJ, Marotta T, et al. Endovascular exclusion of a splenic artery aneurysm using a pipeline embolization device. J Vasc Interv Radiol, 2012, 23(1): 131-135.
22.	Skattum J, Gaarder C, Naess PA. Splenic artery embolisation in children and adolescents-an 8 year experience. Injury, 2014, 45(1): 160-163.
23.	Delaitre B, Maignien B, Icard P. Laparoscopic splenectomy. Br J Surg, 1992, 79(12): 1334.
24.	張杰, 周少波, 褚亮. 經腹腔鏡脾切除治療重度以上脾腫大的療效觀察. 中華腔鏡外科雜志 (電子版), 2012, 5(3): 38-42.
25.	Taher R, Tawfeeq M. Single-port laparoscopic splenectomy for idiopathic thrombocytopenic purpura. Ann Saudi Med, 2011, 31(6): 655-656.
26.	Aparício DJ, Leichsenring C, Rodrigues ?R, et al. Laparoscopic upper pole splenectomy of the simple splenic cyst. BMJ Case Rep, 2013, 2013: bcr2013200438.
27.	趙海峰, 佟立權, 于海英, 等. 腹腔鏡脾切除術在外傷性脾破裂中的應用體會. 中國普外基礎與臨床雜志, 2011, 18(3): 313-316.
28.	李國梁, 藺覓. 腹腔鏡下脾修補術治療外傷性脾破裂 32 例體會. 中華腔鏡外科雜志 (電子版), 2013, 6(1): 55-56.
29.	Wu Z, Zhou J, Pankaj P, et al. Laparoscopic and open splenectomy for splenomegaly secondary to liver cirrhosis: an evaluation of immunity. Surg Endosc, 2012, 26(12): 3557-3564.

1. Kohler JE, Chokshi NK. Management of abdominal solid organ injury after blunt trauma. Pediatr Ann, 2016, 45(7): e241-e246.
2. Soo KM, Lin TY, Chen CW, et al. More becomes less: management strategy has definitely changed over the past decade of splenic injury-a nationwide population-based study. Biomed Res Int, 2015, 2015: 124969.
3. Li Y, Cui L, Zhang W, et al. Laparoscopic radiofrequency ablation for traumatic splenic rupture. J Surg Res, 2013, 185(2): 711-716.
4. 曾憲濤, 劉慧, 陳曦, 等. Meta 分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
5. 鄭俊杰. 閉合性腹外傷并脾破裂行腹腔鏡與開腹手術的療效對比分析. 內蒙古中醫藥, 2013, 32(14): 87-88.
6. 左超海. 腹腔鏡與開腹脾切除術治療創傷性脾破裂的臨床對比. 中外醫療, 2011, 30(34): 22-23.
7. 王祖高. 腹腔鏡手術治療外傷性脾破裂 36 例的臨床研究體會. 中國醫藥導刊, 2013, 15(12): 2008-2009, 2011.
8. 孫海東, 曹健, 穆霄燕, 等. 應用腹腔鏡治療急性創傷性脾破裂臨床研究. 武警后勤學院學報 (醫學版), 2014, 23(3): 199-201.
9. 史群. 腹腔鏡引導下脾切除術治療外傷性脾破裂效果分析. 中國鄉村醫藥, 2014, 21(24): 10-11.
10. 徐斌勇, 蔣揚, 方興保. 腹腔鏡手術治療脾破裂的臨床分析. 腹腔鏡外科雜志, 2015, 20(2): 119-121.
11. 羅曉峰, 王振龍, 何濤, 等. 外傷性脾破裂腹腔鏡與開腹脾切除臨床研究. 嶺南現代臨床外科, 2015, 15(2): 142-145.
12. 李永雙, 謝強, 楊大業, 等. 腹腔鏡和開腹手術治療外傷性脾破裂臨床效果對比分析. 陜西醫學雜志, 2015, 44(2): 194-196.
13. 阿布來提?阿布都熱西提. 腹腔鏡脾切除術與開腹脾切除術治療外傷性脾破裂的臨床對比. 世界最新醫學信息文摘 (電子版), 2016, 16(18): 119, 122.
14. 劉國生, 藺暉琦, 尹照成, 等. 48 例外傷性脾破裂腹腔鏡脾切除的治療體會. 中國實用醫藥, 2016, 11(2): 6-8.
15. 陳文山, 任虎, 魏天天. 腹腔鏡手術治療外傷性脾破裂的臨床效果研究. 數理醫藥學雜志, 2016, 29(11): 1629-1630.
16. 李國莉. 開腹脾切除與腹腔鏡治療外傷性脾破裂的臨床效果對比. 醫藥前沿, 2016, 6(24): 59-60.
17. 張斌, 彭翔, 王群偉, 等. 腹腔鏡治療閉合性腹外傷合并脾破裂的臨床分析. 吉林醫學, 2016, 37(1): 156-157.
18. 王曉東. 手術治療外傷性脾破裂的臨床療效觀察. 世界最新醫學信息文摘 (電子版), 2016, 1(95): 92, 106.
19. 梁平. 外傷性脾破裂手術治療的療效分析. 臨床醫藥文獻電子雜志, 2016, 3(6): 1018-1019.
20. Todd SR. Critical concepts in abdominal injury. Crit Care Clin, 2004, 20(1): 119-134.
21. Abraham RJ, Illyas AJ, Marotta T, et al. Endovascular exclusion of a splenic artery aneurysm using a pipeline embolization device. J Vasc Interv Radiol, 2012, 23(1): 131-135.
22. Skattum J, Gaarder C, Naess PA. Splenic artery embolisation in children and adolescents-an 8 year experience. Injury, 2014, 45(1): 160-163.
23. Delaitre B, Maignien B, Icard P. Laparoscopic splenectomy. Br J Surg, 1992, 79(12): 1334.
24. 張杰, 周少波, 褚亮. 經腹腔鏡脾切除治療重度以上脾腫大的療效觀察. 中華腔鏡外科雜志 (電子版), 2012, 5(3): 38-42.
25. Taher R, Tawfeeq M. Single-port laparoscopic splenectomy for idiopathic thrombocytopenic purpura. Ann Saudi Med, 2011, 31(6): 655-656.
26. Aparício DJ, Leichsenring C, Rodrigues ?R, et al. Laparoscopic upper pole splenectomy of the simple splenic cyst. BMJ Case Rep, 2013, 2013: bcr2013200438.
27. 趙海峰, 佟立權, 于海英, 等. 腹腔鏡脾切除術在外傷性脾破裂中的應用體會. 中國普外基礎與臨床雜志, 2011, 18(3): 313-316.
28. 李國梁, 藺覓. 腹腔鏡下脾修補術治療外傷性脾破裂 32 例體會. 中華腔鏡外科雜志 (電子版), 2013, 6(1): 55-56.
29. Wu Z, Zhou J, Pankaj P, et al. Laparoscopic and open splenectomy for splenomegaly secondary to liver cirrhosis: an evaluation of immunity. Surg Endosc, 2012, 26(12): 3557-3564.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The application effect of laparoscopic versus open surgery in treatment of traumatic rupture of spleen: a meta-analysis

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