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;
ZHOU Tong, Email: zhoutong0088@163.com
traumatic rupture of spleen; laparoscopy; open surgery; effect; meta-analysis
10.7507/1007-9424.201710005
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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

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