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目的探讨胃癌切除术中发生脾损伤的危险因素和处理方法。方法回顾性分析1989年1月至2001年12月胃癌切除术中发生脾损伤患者的资料。结果822例胃癌切除术中发生脾损伤53例,全部为Ⅰ、Ⅱ级损伤。压迫止血1例,填塞缝合21例,脾切除31例。全部治愈出院。结论胃癌手术尤其是经腹近侧胃切除和全胃切除术易发生脾损伤。胃癌切除术中发生的脾损伤多为表浅的Ⅰ、Ⅱ级损伤,用游离的大网膜或肠脂肪垂填塞缝合是简便有效的处理方法。
Objective To investigate the risk factors and treatment of splenic injury in gastric cancer resection. Methods The data of patients with splenic injury during gastric cancer resection from January 1989 to December 2001 were retrospectively analyzed. Results 53 cases of spleen injury occurred in 822 cases of gastric cancer resection, all of them were grade Ⅰ and Ⅱ injuries. 1 case of compression hemostasis, stuffing suture in 21 cases, 31 cases of splenectomy. All cured and discharged. Conclusion Gastric cancer surgery, especially abdominal proximal gastrectomy and total gastrectomy prone to splenic injury. Most splenic injuries occurred during resection of gastric cancer are superficial grade Ⅰ and Ⅱ injuries. It is a simple and effective method to fill sutures with free omentum or intestinal fat.