Hand-assisted laparoscopic splenectomy is a useful surgical treatment method for patients with excessive splenomegaly: A metaanalysis
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摘要
BACKGROUND Hand-assisted laparoscopic splenectomy(HALS) can help overcome the drawbacks of laparoscopic splenectomy(LS) while maintaining its advantages.AIM To evaluate the efficacy and advantages of HALS for splenomegaly.METHODS The relevant literature was reviewed using the PubMed, EMBASE, Cochrane,Ovid Medline, and Wanfang databases to compare the clinical outcomes of HALS and LS. Odds ratios or mean differences were calculated with 95% confidence intervals for fixed-effects and random-effects models. Overall, 754 patients from16 trials who met the inclusion criteria were selected.RESULTS In pure splenectomy, blood loss volume(P < 0.001) and conversion rate(P =0.008) were significantly lower in the HALS group than in the LS group.Conversely, for splenomegaly, the operative time(P = 0.04) was shorter and blood loss volume(P < 0.001) and conversion rate(P = 0.001) were significantly lower in the HALS group than in the LS group. However, no significant difference was observed in hospital stay length, blood transfusion, time to food intake, complications, or mortality rate between the two groups. Moreover, in splenectomy and devascularization of the upper stomach(DUS), the operative time(P = 0.04) was significantly shorter and blood loss volume(P < 0.001) andconversion rate(P = 0.05) were significantly lower in the HALS + DUS group than in the LS + DUS group. However, no significant difference was observed in hospital stay length, timing of diet, and complications between the two groups.CONCLUSION HALS is an ideal surgical treatment method for splenomegaly because it can maximize the benefits for patients while maintaining the advantages of LS.
BACKGROUND Hand-assisted laparoscopic splenectomy(HALS) can help overcome the drawbacks of laparoscopic splenectomy(LS) while maintaining its advantages.AIM To evaluate the efficacy and advantages of HALS for splenomegaly.METHODS The relevant literature was reviewed using the PubMed, EMBASE, Cochrane,Ovid Medline, and Wanfang databases to compare the clinical outcomes of HALS and LS. Odds ratios or mean differences were calculated with 95% confidence intervals for fixed-effects and random-effects models. Overall, 754 patients from16 trials who met the inclusion criteria were selected.RESULTS In pure splenectomy, blood loss volume(P < 0.001) and conversion rate(P =0.008) were significantly lower in the HALS group than in the LS group.Conversely, for splenomegaly, the operative time(P = 0.04) was shorter and blood loss volume(P < 0.001) and conversion rate(P = 0.001) were significantly lower in the HALS group than in the LS group. However, no significant difference was observed in hospital stay length, blood transfusion, time to food intake, complications, or mortality rate between the two groups. Moreover, in splenectomy and devascularization of the upper stomach(DUS), the operative time(P = 0.04) was significantly shorter and blood loss volume(P < 0.001) andconversion rate(P = 0.05) were significantly lower in the HALS + DUS group than in the LS + DUS group. However, no significant difference was observed in hospital stay length, timing of diet, and complications between the two groups.CONCLUSION HALS is an ideal surgical treatment method for splenomegaly because it can maximize the benefits for patients while maintaining the advantages of LS.
BACKGROUND Hand-assisted laparoscopic splenectomy(HALS) can help overcome the drawbacks of laparoscopic splenectomy(LS) while maintaining its advantages.AIM To evaluate the efficacy and advantages of HALS for splenomegaly.METHODS The relevant literature was reviewed using the PubMed, EMBASE, Cochrane,Ovid Medline, and Wanfang databases to compare the clinical outcomes of HALS and LS. Odds ratios or mean differences were calculated with 95% confidence intervals for fixed-effects and random-effects models. Overall, 754 patients from16 trials who met the inclusion criteria were selected.RESULTS In pure splenectomy, blood loss volume(P < 0.001) and conversion rate(P =0.008) were significantly lower in the HALS group than in the LS group.Conversely, for splenomegaly, the operative time(P = 0.04) was shorter and blood loss volume(P < 0.001) and conversion rate(P = 0.001) were significantly lower in the HALS group than in the LS group. However, no significant difference was observed in hospital stay length, blood transfusion, time to food intake, complications, or mortality rate between the two groups. Moreover, in splenectomy and devascularization of the upper stomach(DUS), the operative time(P = 0.04) was significantly shorter and blood loss volume(P < 0.001) andconversion rate(P = 0.05) were significantly lower in the HALS + DUS group than in the LS + DUS group. However, no significant difference was observed in hospital stay length, timing of diet, and complications between the two groups.CONCLUSION HALS is an ideal surgical treatment method for splenomegaly because it can maximize the benefits for patients while maintaining the advantages of LS.
引文
1 Xu W,Liu P,Mu YP.Research progress on signaling pathways in cirrhotic portal hypertension.World JClin Cases 2018;6:335-343[PMID:30283796 DOI:10.12998/wjcc.v6.i10.335]
2 Su MH,Lu AL,Li SH,Zhong SH,Wang BJ,Wu XL,Mo YY,Liang P,Liu ZH,Xie R,He LX,Fu WD,Jiang JN.Long-term lamivudine for chronic hepatitis B and cirrhosis:A real-life cohort study.World JGastroenterol 2015;21:13087-13094[PMID:26673249 DOI:10.3748/wjg.v21.i46.13087]
3 Ioannou GN.Chronic hepatitis B infection:a global disease requiring global strategies.Hepatology 2013;58:839-843[PMID:23703788 DOI:10.1002/hep.26516]
4 Jiang X,Gao F,Ma Y,Feng S,Liu X,Zhou H.Percutaneous Microwave Ablation in the Spleen for Treatment of Hypersplenism in Cirrhosis Patients.Dig Dis Sci 2016;61:287-292[PMID:26031423 DOI:10.1007/s10620-015-3732-7]
5 Jensen DM.Endoscopic screening for varices in cirrhosis:findings,implications,and outcomes.Gastroenterology 2002;122:1620-1630[PMID:12016427 DOI:10.1053/gast.2002.33419]
6 Zhan XL,Ji Y,Wang YD.Laparoscopic splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension.World J Gastroenterol 2014;20:5794-5800[PMID:24914339 DOI:10.3748/wjg.v20.i19.5794]
7 Habermalz B,Sauerland S,Decker G,Delaitre B,Gigot JF,Leandros E,Lechner K,Rhodes M,Silecchia G,Szold A,Targarona E,Torelli P,Neugebauer E.Laparoscopic splenectomy:the clinical practice guidelines of the European Association for Endoscopic Surgery(EAES).Surg Endosc 2008;22:821-848[PMID:18293036 DOI:10.1007/s00464-007-9735-5]
8 Knauer EM,Ailawadi G,Yahanda A,Obermeyer RJ,Millie MP,Ojeda H,Mulholland MW,Colletti L,Sweeney JF.101 laparoscopic splenectomies for the treatment of benign and malignant hematologic disorders.Am J Surg 2003;186:500-504[PMID:14599614 DOI:10.1016/j.amjsurg.2003.07.026]
9 Owera A,Hamade AM,Bani Hani OI,Ammori BJ.Laparoscopic versus open splenectomy for massive splenomegaly:a comparative study.J Laparoendosc Adv Surg Tech A 2006;16:241-246[PMID:16796432 DOI:10.1089/lap.2006.16.241]
10 Meijer DW,Gossot D,Jakimowicz JJ,De Wit LT,Bannenberg JJ,Gouma DJ.Splenectomy revised:manually assisted splenectomy with the dexterity device--a feasibility study in 22 patients.J Laparoendosc Adv Surg Tech A 1999;9:507-510[PMID:10632513 DOI:10.1089/lap.1999.9.507]
11 Targarona EM,Balague C,Cerdán G,Espert JJ,Lacy AM,Visa J,Trias M.Hand-assisted laparoscopic splenectomy(HALS)in cases of splenomegaly:a comparison analysis with conventional laparoscopic splenectomy.Surg Endosc 2002;16:426-430[PMID:11928021 DOI:10.1007/s00464-001-8104-z]
12 Terrosu G,Donini A,Baccarani U,Vianello V,Anania G,Zala F,Pasqualucci A,Bresadola F.Laparoscopic versus open splenectomy in the management of splenomegaly:our preliminary experience.Surgery 1998;124:839-843[PMID:9823396 DOI:10.1016/S0039-6060(98)70006-6]
13 Targarona EM,Espert JJ,BalaguéC,Piulachs J,Artigas V,Trias M.Splenomegaly should not be considered a contraindication for laparoscopic splenectomy.Ann Surg 1998;228:35-39[PMID:9671064DOI:10.1097/00000658-199807000-00006]
14 Wang X,Li Y,Zhou J,Wu Z,Peng B.Hand-assisted laparoscopic splenectomy is a better choice for patients with supramassive splenomegaly due to liver cirrhosis.J Laparoendosc Adv Surg Tech A 2012;22:962-967[PMID:23067068 DOI:10.1089/lap.2012.0237]
15 Grahn SW,Alvarez J,Kirkwood K.Trends in laparoscopic splenectomy for massive splenomegaly.Arch Surg 2006;141:755-761;discussion 761-762[PMID:16924082 DOI:10.1001/archsurg.141.8.755]
16 Qian D,He Z,Hua J,Gong J,Lin S,Song Z.Hand-assisted versus conventional laparoscopic splenectomy:a systematic review and meta-analysis.ANZ J Surg 2014;84:915-920[PMID:24712437DOI:10.1111/ans.12597]
17 Cota GF,de Sousa MR,Fereguetti TO,Rabello A.Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients:a systematic review with indirect comparison.PLoS Negl Trop Dis 2013;7:e2195[PMID:23658850 DOI:10.1371/journal.pntd.0002195]
18 Hozo SP,Djulbegovic B,Hozo I.Estimating the mean and variance from the median,range,and the size of a sample.BMC Med Res Methodol 2005;5:13[PMID:15840177 DOI:10.1186/1471-2288-5-13]
19 Feng Q,Huang Y,Wang K,Yuan R,Xiong X,Wu L.Laparoscopic Transcystic Common Bile Duct Exploration:Advantages over Laparoscopic Choledochotomy.PLoS One 2016;11:e0162885[PMID:27668730 DOI:10.1371/journal.pone.0162885]
20 Ailawadi G,Yahanda A,Dimick JB,Bedi A,Mulholland MW,Colletti L,Sweeney JF.Hand-assisted laparoscopic splenectomy in patients with splenomegaly or prior upper abdominal operation.Surgery2002;132:689-94;discussion 694-6[PMID:12407354 DOI:10.1067/msy.2002.127686]
21 Kercher KW,Matthews BD,Walsh RM,Sing RF,Backus CL,Heniford BT.Laparoscopic splenectomy for massive splenomegaly.Am J Surg 2002;183:192-196[PMID:11918887 DOI:10.1016/S0002-9610(01)00874-1]
22 Rosen M,Brody F,Walsh RM,Ponsky J.Hand-assisted laparoscopic splenectomy vs conventional laparoscopic splenectomy in cases of splenomegaly.Arch Surg 2002;137:1348-1352[PMID:12470097DOI:10.1001/archsurg.137.12.1348]
23 Smith L,Luna G,Merg AR,McNevin MS,Moore MR,Bax TW.Laparoscopic splenectomy for treatment of splenomegaly.Am J Surg 2004;187:618-620[PMID:15135677 DOI:10.1016/j.amjsurg.2004.01.016]
24 Wang KX,Hu SY,Zhang GY,Chen B,Zhang HF.Hand-assisted laparoscopic splenectomy for splenomegaly:a comparative study with conventional laparoscopic splenectomy.Chin Med J(Engl)2007;120:41-45[PMID:17254486]
25 Reso A,Brar MS,Church N,Mitchell P,Dixon E,Debru E.Outcome of laparoscopic splenectomy with preoperative splenic artery embolization for massive splenomegaly.Surg Endosc 2010;24:2008-2012[PMID:20419317 DOI:10.1007/s00464-010-0896-2]
26 Pietrabissa A,Morelli L,Peri A,Pugliese L,Zonta S,Dionigi P,Mosca F.Laparoscopic treatment of splenomegaly:a case for hand-assisted laparoscopic surgery.Arch Surg 2011;146:818-823[PMID:21768428 DOI:10.1001/archsurg.2011.149]
27 Altaf AM,Ellsmere J,Jaap Bonjer H,El-Ghazaly TH,Klassen DR.Morbidity of hand-assisted laparoscopic splenectomy compared to conventional laparoscopic splenectomy:a 6-year review.Can JSurg 2012;55:227-232[PMID:22617537 DOI:10.1503/cjs.028910]
28 Wang X,Li Y,Peng B.Hand-assisted laparoscopic technique in the setting of complicated splenectomy:a9-year experience.World J Surg 2013;37:2046-2052[PMID:23756773 DOI:10.1007/s00268-013-2114-6]
29 Ando K,Kurokawa T,Nagata H,Arikawa T,Yasuda A,Ito N,Kotake K,Nonami T.Laparoscopic surgery in the management of hypersplenism and esophagogastric varices:our initial experiences.Surg Innov 2012;19:421-427[PMID:22298753 DOI:10.1177/1553350611432724]
30 Li E,Wu Z,Liu H,Li Z,Chen K,Zhang Z,Zhang R,Zeng H.A comparative study of hand-assisted laparoscopic versus total laparoscopic splenectomy plus portal-azygous disconnection for portal hypertension in liver cirrhosis.Lingnan Xiandai Linchuang Waike 2013;13:489-492[DOI:10.3969/j.issn.1009-976X.2013.06.005]
31 Yu H,Chen H,Chen L,Jin X.A comparative study on the clinical efficacy of splenectomy plus portaazygous devascularization in the treatment of portal hypertension using either the hand-assisted or the laparoscopic approaches.Zhonghua Gandan Waike Zazhi 2013;19:370-372[DOI:10.3760/cma.j.issn.1007-8118.2013.05.015]
32 Akahoshi T,Uehara H,Tomikawa M,Kawanaka H,Hashizume M,Maehara Y.Comparison of open,laparoscopic,and hand-assisted laparoscopic devascularization of the upper stomach and splenectomy for treatment of esophageal and gastric varices:a single-center experience.Asian J Endosc Surg 2014;7:138-144[PMID:24571442 DOI:10.1111/ases.12096]
33 Li Q,Wang C,Gong W,Li G.Clinical Comparative Effect of Laparoscopic Splenectomy Plus Handassisted Laparoscopic Splenectomy Plus Pericardial Devascularization.Zhongguo Yiyao Daobao 2016;18:1006-1010
34 Kusminsky RE,Boland JP,Tiley EH,Deluca JA.Hand-assisted laparoscopic splenectomy.Surg Laparosc Endosc 1995;5:463-467[PMID:8611994]
35 Winslow ER,Brunt LM.Perioperative outcomes of laparoscopic versus open splenectomy:a metaanalysis with an emphasis on complications.Surgery 2003;134:647-653;discussion 654-655[PMID:14605626 DOI:10.1016/S0039-6060(03)00312-X]
36 Kaban GK,Czerniach DR,Litwin DE,Litwin DE.Hand-assisted laparoscopic surgery.Surg Technol Int2003;11:63-70[PMID:12931285]
37 Litwin DE,Darzi A,Jakimowicz J,Kelly JJ,Arvidsson D,Hansen P,Callery MP,Denis R,Fowler DL,Medich DS,O'Reilly MJ,Atlas H,Himpens JM,Swanstrom LL,Arous EJ,Pattyn P,Yood SM,Ricciardi R,Sandor A,Meyers WC.Hand-assisted laparoscopic surgery(HALS)with the HandPort system:initial experience with 68 patients.Ann Surg 2000;231:715-723[PMID:10767793 DOI:10.1097/00000658-200005000-00012]
38 Gong J,Cao Y,Li Y,Zhang G,Wang P,Luo G.Hand-assisted laparoscopic versus laparoscopy-assisted D2 radical gastrectomy:a prospective study.Surg Endosc 2014;28:2998-3006[PMID:24879135 DOI:10.1007/s00464-014-3566-y]
39 Wang ZQ.Application and indication choice of hand-assisted laparoscopic operation in gastrointestinal surgery.Zhonghua Weichang Waike Zazhi 2012;15:796-798[PMID:23072019]
40 Klingler PJ,Hinder RA,Menke DM,Smith SL.Hand-assisted laparoscopic distal pancreatectomy for pancreatic cystadenoma.Surg Laparosc Endosc 1998;8:180-184[PMID:9649039 DOI:10.1097/00019509-199806000-00003]
41 Shinchi H,Takao S,Noma H,Mataki Y,Iino S,Aikou T.Hand-assisted laparoscopic distal pancreatectomy with minilaparotomy for distal pancreatic cystadenoma.Surg Laparosc Endosc Percutan Tech 2001;11:139-143[PMID:11330382 DOI:10.1097/00129689-200104000-00016]
42 Kercher KW,Joels CS,Matthews BD,Lincourt AE,Smith TI,Heniford BT.Hand-assisted surgery improves outcomes for laparoscopic nephrectomy.Am Surg 2003;69:1061-1066[PMID:14700291]
43 Tanaka M,Tokuda N,Koga H,Yokomizo A,Sakamoto N,Naito S.Hand assisted laparoscopic radical nephrectomy for renal carcinoma using a new abdominal wall sealing device.J Urol 2000;164:314-318[PMID:10893573 DOI:10.1016/S0022-5347(05)67348-X]
44 Fong Y,Jarnagin W,Conlon KC,DeMatteo R,Dougherty E,Blumgart LH.Hand-assisted laparoscopic liver resection:lessons from an initial experience.Arch Surg 2000;135:854-859[PMID:10896382 DOI:10.1001/archsurg.135.7.854]
45 Salit Y,Bitterman A,Lefel O,Eisenberg D,Eden A,Barzelai M,Steiner M,Zuckerman E,Haddad R.Hand-assisted laparoscopic surgery for liver tumors.Isr Med Assoc J 2010;12:424-427[PMID:20862824]
2 Su MH,Lu AL,Li SH,Zhong SH,Wang BJ,Wu XL,Mo YY,Liang P,Liu ZH,Xie R,He LX,Fu WD,Jiang JN.Long-term lamivudine for chronic hepatitis B and cirrhosis:A real-life cohort study.World JGastroenterol 2015;21:13087-13094[PMID:26673249 DOI:10.3748/wjg.v21.i46.13087]
3 Ioannou GN.Chronic hepatitis B infection:a global disease requiring global strategies.Hepatology 2013;58:839-843[PMID:23703788 DOI:10.1002/hep.26516]
4 Jiang X,Gao F,Ma Y,Feng S,Liu X,Zhou H.Percutaneous Microwave Ablation in the Spleen for Treatment of Hypersplenism in Cirrhosis Patients.Dig Dis Sci 2016;61:287-292[PMID:26031423 DOI:10.1007/s10620-015-3732-7]
5 Jensen DM.Endoscopic screening for varices in cirrhosis:findings,implications,and outcomes.Gastroenterology 2002;122:1620-1630[PMID:12016427 DOI:10.1053/gast.2002.33419]
6 Zhan XL,Ji Y,Wang YD.Laparoscopic splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension.World J Gastroenterol 2014;20:5794-5800[PMID:24914339 DOI:10.3748/wjg.v20.i19.5794]
7 Habermalz B,Sauerland S,Decker G,Delaitre B,Gigot JF,Leandros E,Lechner K,Rhodes M,Silecchia G,Szold A,Targarona E,Torelli P,Neugebauer E.Laparoscopic splenectomy:the clinical practice guidelines of the European Association for Endoscopic Surgery(EAES).Surg Endosc 2008;22:821-848[PMID:18293036 DOI:10.1007/s00464-007-9735-5]
8 Knauer EM,Ailawadi G,Yahanda A,Obermeyer RJ,Millie MP,Ojeda H,Mulholland MW,Colletti L,Sweeney JF.101 laparoscopic splenectomies for the treatment of benign and malignant hematologic disorders.Am J Surg 2003;186:500-504[PMID:14599614 DOI:10.1016/j.amjsurg.2003.07.026]
9 Owera A,Hamade AM,Bani Hani OI,Ammori BJ.Laparoscopic versus open splenectomy for massive splenomegaly:a comparative study.J Laparoendosc Adv Surg Tech A 2006;16:241-246[PMID:16796432 DOI:10.1089/lap.2006.16.241]
10 Meijer DW,Gossot D,Jakimowicz JJ,De Wit LT,Bannenberg JJ,Gouma DJ.Splenectomy revised:manually assisted splenectomy with the dexterity device--a feasibility study in 22 patients.J Laparoendosc Adv Surg Tech A 1999;9:507-510[PMID:10632513 DOI:10.1089/lap.1999.9.507]
11 Targarona EM,Balague C,Cerdán G,Espert JJ,Lacy AM,Visa J,Trias M.Hand-assisted laparoscopic splenectomy(HALS)in cases of splenomegaly:a comparison analysis with conventional laparoscopic splenectomy.Surg Endosc 2002;16:426-430[PMID:11928021 DOI:10.1007/s00464-001-8104-z]
12 Terrosu G,Donini A,Baccarani U,Vianello V,Anania G,Zala F,Pasqualucci A,Bresadola F.Laparoscopic versus open splenectomy in the management of splenomegaly:our preliminary experience.Surgery 1998;124:839-843[PMID:9823396 DOI:10.1016/S0039-6060(98)70006-6]
13 Targarona EM,Espert JJ,BalaguéC,Piulachs J,Artigas V,Trias M.Splenomegaly should not be considered a contraindication for laparoscopic splenectomy.Ann Surg 1998;228:35-39[PMID:9671064DOI:10.1097/00000658-199807000-00006]
14 Wang X,Li Y,Zhou J,Wu Z,Peng B.Hand-assisted laparoscopic splenectomy is a better choice for patients with supramassive splenomegaly due to liver cirrhosis.J Laparoendosc Adv Surg Tech A 2012;22:962-967[PMID:23067068 DOI:10.1089/lap.2012.0237]
15 Grahn SW,Alvarez J,Kirkwood K.Trends in laparoscopic splenectomy for massive splenomegaly.Arch Surg 2006;141:755-761;discussion 761-762[PMID:16924082 DOI:10.1001/archsurg.141.8.755]
16 Qian D,He Z,Hua J,Gong J,Lin S,Song Z.Hand-assisted versus conventional laparoscopic splenectomy:a systematic review and meta-analysis.ANZ J Surg 2014;84:915-920[PMID:24712437DOI:10.1111/ans.12597]
17 Cota GF,de Sousa MR,Fereguetti TO,Rabello A.Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients:a systematic review with indirect comparison.PLoS Negl Trop Dis 2013;7:e2195[PMID:23658850 DOI:10.1371/journal.pntd.0002195]
18 Hozo SP,Djulbegovic B,Hozo I.Estimating the mean and variance from the median,range,and the size of a sample.BMC Med Res Methodol 2005;5:13[PMID:15840177 DOI:10.1186/1471-2288-5-13]
19 Feng Q,Huang Y,Wang K,Yuan R,Xiong X,Wu L.Laparoscopic Transcystic Common Bile Duct Exploration:Advantages over Laparoscopic Choledochotomy.PLoS One 2016;11:e0162885[PMID:27668730 DOI:10.1371/journal.pone.0162885]
20 Ailawadi G,Yahanda A,Dimick JB,Bedi A,Mulholland MW,Colletti L,Sweeney JF.Hand-assisted laparoscopic splenectomy in patients with splenomegaly or prior upper abdominal operation.Surgery2002;132:689-94;discussion 694-6[PMID:12407354 DOI:10.1067/msy.2002.127686]
21 Kercher KW,Matthews BD,Walsh RM,Sing RF,Backus CL,Heniford BT.Laparoscopic splenectomy for massive splenomegaly.Am J Surg 2002;183:192-196[PMID:11918887 DOI:10.1016/S0002-9610(01)00874-1]
22 Rosen M,Brody F,Walsh RM,Ponsky J.Hand-assisted laparoscopic splenectomy vs conventional laparoscopic splenectomy in cases of splenomegaly.Arch Surg 2002;137:1348-1352[PMID:12470097DOI:10.1001/archsurg.137.12.1348]
23 Smith L,Luna G,Merg AR,McNevin MS,Moore MR,Bax TW.Laparoscopic splenectomy for treatment of splenomegaly.Am J Surg 2004;187:618-620[PMID:15135677 DOI:10.1016/j.amjsurg.2004.01.016]
24 Wang KX,Hu SY,Zhang GY,Chen B,Zhang HF.Hand-assisted laparoscopic splenectomy for splenomegaly:a comparative study with conventional laparoscopic splenectomy.Chin Med J(Engl)2007;120:41-45[PMID:17254486]
25 Reso A,Brar MS,Church N,Mitchell P,Dixon E,Debru E.Outcome of laparoscopic splenectomy with preoperative splenic artery embolization for massive splenomegaly.Surg Endosc 2010;24:2008-2012[PMID:20419317 DOI:10.1007/s00464-010-0896-2]
26 Pietrabissa A,Morelli L,Peri A,Pugliese L,Zonta S,Dionigi P,Mosca F.Laparoscopic treatment of splenomegaly:a case for hand-assisted laparoscopic surgery.Arch Surg 2011;146:818-823[PMID:21768428 DOI:10.1001/archsurg.2011.149]
27 Altaf AM,Ellsmere J,Jaap Bonjer H,El-Ghazaly TH,Klassen DR.Morbidity of hand-assisted laparoscopic splenectomy compared to conventional laparoscopic splenectomy:a 6-year review.Can JSurg 2012;55:227-232[PMID:22617537 DOI:10.1503/cjs.028910]
28 Wang X,Li Y,Peng B.Hand-assisted laparoscopic technique in the setting of complicated splenectomy:a9-year experience.World J Surg 2013;37:2046-2052[PMID:23756773 DOI:10.1007/s00268-013-2114-6]
29 Ando K,Kurokawa T,Nagata H,Arikawa T,Yasuda A,Ito N,Kotake K,Nonami T.Laparoscopic surgery in the management of hypersplenism and esophagogastric varices:our initial experiences.Surg Innov 2012;19:421-427[PMID:22298753 DOI:10.1177/1553350611432724]
30 Li E,Wu Z,Liu H,Li Z,Chen K,Zhang Z,Zhang R,Zeng H.A comparative study of hand-assisted laparoscopic versus total laparoscopic splenectomy plus portal-azygous disconnection for portal hypertension in liver cirrhosis.Lingnan Xiandai Linchuang Waike 2013;13:489-492[DOI:10.3969/j.issn.1009-976X.2013.06.005]
31 Yu H,Chen H,Chen L,Jin X.A comparative study on the clinical efficacy of splenectomy plus portaazygous devascularization in the treatment of portal hypertension using either the hand-assisted or the laparoscopic approaches.Zhonghua Gandan Waike Zazhi 2013;19:370-372[DOI:10.3760/cma.j.issn.1007-8118.2013.05.015]
32 Akahoshi T,Uehara H,Tomikawa M,Kawanaka H,Hashizume M,Maehara Y.Comparison of open,laparoscopic,and hand-assisted laparoscopic devascularization of the upper stomach and splenectomy for treatment of esophageal and gastric varices:a single-center experience.Asian J Endosc Surg 2014;7:138-144[PMID:24571442 DOI:10.1111/ases.12096]
33 Li Q,Wang C,Gong W,Li G.Clinical Comparative Effect of Laparoscopic Splenectomy Plus Handassisted Laparoscopic Splenectomy Plus Pericardial Devascularization.Zhongguo Yiyao Daobao 2016;18:1006-1010
34 Kusminsky RE,Boland JP,Tiley EH,Deluca JA.Hand-assisted laparoscopic splenectomy.Surg Laparosc Endosc 1995;5:463-467[PMID:8611994]
35 Winslow ER,Brunt LM.Perioperative outcomes of laparoscopic versus open splenectomy:a metaanalysis with an emphasis on complications.Surgery 2003;134:647-653;discussion 654-655[PMID:14605626 DOI:10.1016/S0039-6060(03)00312-X]
36 Kaban GK,Czerniach DR,Litwin DE,Litwin DE.Hand-assisted laparoscopic surgery.Surg Technol Int2003;11:63-70[PMID:12931285]
37 Litwin DE,Darzi A,Jakimowicz J,Kelly JJ,Arvidsson D,Hansen P,Callery MP,Denis R,Fowler DL,Medich DS,O'Reilly MJ,Atlas H,Himpens JM,Swanstrom LL,Arous EJ,Pattyn P,Yood SM,Ricciardi R,Sandor A,Meyers WC.Hand-assisted laparoscopic surgery(HALS)with the HandPort system:initial experience with 68 patients.Ann Surg 2000;231:715-723[PMID:10767793 DOI:10.1097/00000658-200005000-00012]
38 Gong J,Cao Y,Li Y,Zhang G,Wang P,Luo G.Hand-assisted laparoscopic versus laparoscopy-assisted D2 radical gastrectomy:a prospective study.Surg Endosc 2014;28:2998-3006[PMID:24879135 DOI:10.1007/s00464-014-3566-y]
39 Wang ZQ.Application and indication choice of hand-assisted laparoscopic operation in gastrointestinal surgery.Zhonghua Weichang Waike Zazhi 2012;15:796-798[PMID:23072019]
40 Klingler PJ,Hinder RA,Menke DM,Smith SL.Hand-assisted laparoscopic distal pancreatectomy for pancreatic cystadenoma.Surg Laparosc Endosc 1998;8:180-184[PMID:9649039 DOI:10.1097/00019509-199806000-00003]
41 Shinchi H,Takao S,Noma H,Mataki Y,Iino S,Aikou T.Hand-assisted laparoscopic distal pancreatectomy with minilaparotomy for distal pancreatic cystadenoma.Surg Laparosc Endosc Percutan Tech 2001;11:139-143[PMID:11330382 DOI:10.1097/00129689-200104000-00016]
42 Kercher KW,Joels CS,Matthews BD,Lincourt AE,Smith TI,Heniford BT.Hand-assisted surgery improves outcomes for laparoscopic nephrectomy.Am Surg 2003;69:1061-1066[PMID:14700291]
43 Tanaka M,Tokuda N,Koga H,Yokomizo A,Sakamoto N,Naito S.Hand assisted laparoscopic radical nephrectomy for renal carcinoma using a new abdominal wall sealing device.J Urol 2000;164:314-318[PMID:10893573 DOI:10.1016/S0022-5347(05)67348-X]
44 Fong Y,Jarnagin W,Conlon KC,DeMatteo R,Dougherty E,Blumgart LH.Hand-assisted laparoscopic liver resection:lessons from an initial experience.Arch Surg 2000;135:854-859[PMID:10896382 DOI:10.1001/archsurg.135.7.854]
45 Salit Y,Bitterman A,Lefel O,Eisenberg D,Eden A,Barzelai M,Steiner M,Zuckerman E,Haddad R.Hand-assisted laparoscopic surgery for liver tumors.Isr Med Assoc J 2010;12:424-427[PMID:20862824]