Safety and efficacy of high-temperature wet coagulation hemostasis in laparoscopic partial splenectomy for benign splenic lesions

doi:10.3877/cma.j.issn.2095-3232.2026.01.016

Abstract

Abstract:

Objective

To evaluate the safety and efficacy of high-temperature wet coagulation in laparoscopic partial splenectomy (LPS) for the treatment of benign splenic lesions.

Methods

Clinical data of 47 patients with benign splenic lesions who underwent LPS in the First Affiliated Hospital of Air Military Medical University from January 2015 to December 2024 were retrospectively analyzed. The informed consents of all patients or family members were obtained and the local ethical committee approval was received. Among them, 26 patients were male and 21 female, aged from 13 to 65 years, with a median age of 29 years. All patients were diagnosed with space-occupying lesions of the spleen by CT scan and other imaging examinations before operation. According to different hemostasis methods, they were divided into three groups: high-temperature wet coagulation, bipolar electrocoagulation and cutting stapler groups. Hemostasis effects were compared among three groups.

Results

47 patients successfully underwent LPS, with no conversion to open surgery. Intraoperative blood loss was 100(88) ml in high-temperature wet coagulation group, 300(480) ml in bipolar electrocoagulation group and 100(148) ml in cutting stapler group, with no statistical significance (H=0.914, all P>0.05). Postoperatively, 5 patients experienced a slight amount of pleural effusion and 3 cases of mild pelvic effusion, which healed spontaneously without additional treatment. No postoperative complications such as infection, pancreatic leakage, bleeding, thrombosis and splenic ischemic infarction were observed. All patients were successfully discharged. Postoperative pathological examination revealed that 32 cases developed splenic cyst, 10 cases of splenic hemangioma, 2 cases of splenic angioma and 3 cases of splenic lymphangioma, respectively.

Conclusions

Three different hemostasis methods are safe and efficacious in LPS for benign splenic lesions. Compared with traditional hemostasis methods of cutting stapler and bipolar electrocoagulation, high-temperature wet coagulation hemostasis is a more universal procedure.

Key words: Laparoscopic, Partial splenectomy, Benign diseases of the spleen, high-temperature wet coagulation method, Hemostasis methods

Bo Nan, Yunhu Bai, Feifei Wu, Yanling Yang. Safety and efficacy of high-temperature wet coagulation hemostasis in laparoscopic partial splenectomy for benign splenic lesions[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2026, 15(01): 101-107.

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Figures/Tables 4

指标	高温湿凝组	双极电凝组	切割闭合器组	统计值	P值
性别(例, 男/女)	9/7	6/5	11/9	-	>0.999
年龄[岁, M(Q_R)]	27(21)	29(34)	28(19)	H=0.020	0.999
BMI(kg/m², $x ¯$ ±s)	22±4	21±3	23±4	F=1.500	0.234
ALT[U/L, M(Q_R)]	12(19)	18(25)	14(9)	H=0.202	0.904
AST[U/L, M(Q_R)]	18.0(7.0)	17.0(10.0)	16.5(6.0)	H=1.343	0.511
ALB[g/L, M(Q_R)]	40(6)	47(4)	46(5)	H=1.259	0.533
A/G( $x ¯$ ±s)	1.71±0.36	1.89±0.30	1.76±0.28	F=1.160	0.323
尿素[mmol/L, M(Q_R)]	5.5±1.6	5.4±1.8	4.6±1.0	F=2.375	0.105
Scr[μmol/L, M(Q_R)]	72(27)	64(19)	66(22)	F=1.362	0.506
PT(s, $x ¯$ ±s)	10.2±1.3	10.1±3.0	10.3±1.3	F=0.035	0.966
APTT(s, $x ¯$ ±s)	31±4	31±6	30±5	F=0.206	0.814
FIB[g/L, M(Q_R)]	2.95(1.16)	2.59(0.68)	2.91(0.66)	H=6.254	0.044
TT(s, $x ¯$ ±s)	17.3±0.9	18.2±1.0	18.0±1.1	F=3.006	0.060
PTA(%, $x ¯$ ±s)	94±16	95±15	95±11	F=0.047	0.954
WBC[×10⁹/L, M(Q_R)]	6.55(2.34)	5.71(2.80)	5.90 (1.75)	H=2.777	0.249
中性粒细胞百分率(%, $x ¯$ ±s)	62±14	59±9	62±8	F=0.468	0.629
Hb(g/L, $x ¯$ ±s)	140±19	149±17	139±17	F=1.302	0.282
Plt(×10⁹/L, $x ¯$ ±s)	209±69	191±56	188±44	F=0.677	0.513
肿瘤位置(例, 上极/中极/下极)	13/1/2	12/1/2	8/3/9	-	0.113
肿瘤直径[cm, M(Q_R)]	7.7(4.2)	8.4(6.2)	7.3(3.9)	H=0.402	0.818

指标	高温湿凝组	双极电凝组	切割闭合器组	统计值	P值
性别(例, 男/女)	9/7	6/5	11/9	-	>0.999
年龄[岁, M(Q_R)]	27(21)	29(34)	28(19)	H=0.020	0.999
BMI(kg/m², $x ¯$ ±s)	22±4	21±3	23±4	F=1.500	0.234
ALT[U/L, M(Q_R)]	12(19)	18(25)	14(9)	H=0.202	0.904
AST[U/L, M(Q_R)]	18.0(7.0)	17.0(10.0)	16.5(6.0)	H=1.343	0.511
ALB[g/L, M(Q_R)]	40(6)	47(4)	46(5)	H=1.259	0.533
A/G( $x ¯$ ±s)	1.71±0.36	1.89±0.30	1.76±0.28	F=1.160	0.323
尿素[mmol/L, M(Q_R)]	5.5±1.6	5.4±1.8	4.6±1.0	F=2.375	0.105
Scr[μmol/L, M(Q_R)]	72(27)	64(19)	66(22)	F=1.362	0.506
PT(s, $x ¯$ ±s)	10.2±1.3	10.1±3.0	10.3±1.3	F=0.035	0.966
APTT(s, $x ¯$ ±s)	31±4	31±6	30±5	F=0.206	0.814
FIB[g/L, M(Q_R)]	2.95(1.16)	2.59(0.68)	2.91(0.66)	H=6.254	0.044
TT(s, $x ¯$ ±s)	17.3±0.9	18.2±1.0	18.0±1.1	F=3.006	0.060
PTA(%, $x ¯$ ±s)	94±16	95±15	95±11	F=0.047	0.954
WBC[×10⁹/L, M(Q_R)]	6.55(2.34)	5.71(2.80)	5.90 (1.75)	H=2.777	0.249
中性粒细胞百分率(%, $x ¯$ ±s)	62±14	59±9	62±8	F=0.468	0.629
Hb(g/L, $x ¯$ ±s)	140±19	149±17	139±17	F=1.302	0.282
Plt(×10⁹/L, $x ¯$ ±s)	209±69	191±56	188±44	F=0.677	0.513
肿瘤位置(例, 上极/中极/下极)	13/1/2	12/1/2	8/3/9	-	0.113
肿瘤直径[cm, M(Q_R)]	7.7(4.2)	8.4(6.2)	7.3(3.9)	H=0.402	0.818

变量	高温湿凝组	双极电凝组	切割闭合器组	统计值	P值
手术时间[min, M(Q_R)]	138(72)	135(60)	130(55)	H=0.454	0.797
出血量[ml, M(Q_R)]	100(88)	300(480)	100(148)	H=0.914	0.633
术后拔管时间[d, M(Q_R)]	4.0(3.0)	4.0 (2.0)	3.5 (2.0)	H=2.583	0.275
术后排气时间[d, M(Q_R)]	2.0(1.0)	2.0(1.0)	2.0(1.0)	H=0.726	0.696
术后住院时间[d, M(Q_R)]	6.0(1.0)	6.0(4.0)	6.0(2.0)	H=0.236	0.889
术后第1天引流量(ml, $x ¯$ ±s)	68±39	53±33	42±35	F=2.239	0.119
术后第2天引流量[ml, M(Q_R)]	50(56)	20(40)	25(50)	H=2.187	0.335
术后第3天引流量[ml, M(Q_R)]	20(44)	20(45)	13(50)	H=0.880	0.644

变量	高温湿凝组	双极电凝组	切割闭合器组	统计值	P值
手术时间[min, M(Q_R)]	138(72)	135(60)	130(55)	H=0.454	0.797
出血量[ml, M(Q_R)]	100(88)	300(480)	100(148)	H=0.914	0.633
术后拔管时间[d, M(Q_R)]	4.0(3.0)	4.0 (2.0)	3.5 (2.0)	H=2.583	0.275
术后排气时间[d, M(Q_R)]	2.0(1.0)	2.0(1.0)	2.0(1.0)	H=0.726	0.696
术后住院时间[d, M(Q_R)]	6.0(1.0)	6.0(4.0)	6.0(2.0)	H=0.236	0.889
术后第1天引流量(ml, $x ¯$ ±s)	68±39	53±33	42±35	F=2.239	0.119
术后第2天引流量[ml, M(Q_R)]	50(56)	20(40)	25(50)	H=2.187	0.335
术后第3天引流量[ml, M(Q_R)]	20(44)	20(45)	13(50)	H=0.880	0.644

病理诊断	高温湿凝组	双极电凝组	切割闭合器组	统计值	P值
脾囊肿	14	7	11	-	0.410
脾血管瘤	2	3	5
脾脉管瘤	0	0	2
脾淋巴管瘤	0	1	2

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