Laparoscopic versus open splenectomy for nontraumatic diseases.

Details

Serval ID
serval:BIB_850C1D62B7F1
Type
Article: article from journal or magazin.
Collection
Publications
Title
Laparoscopic versus open splenectomy for nontraumatic diseases.
Journal
World journal of surgery
Author(s)
Maurus C.F., Schäfer M., Müller M.K., Clavien P.A., Weber M.
ISSN
0364-2313 (Print)
ISSN-L
0364-2313
Publication state
Published
Issued date
11/2008
Peer-reviewed
Oui
Volume
32
Number
11
Pages
2444-2449
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Laparoscopic splenectomy (LS) is the standard procedure for normal size or moderately enlarged spleens; open splenectomy (OS) is preferred in cases of splenomegaly. In this study, indications for and complications of open and laparoscopic splenectomy were analyzed, with the aim to identify patients who will benefit from either technique.
A consecutive series of 52 patients undergoing elective open or laparoscopic splenectomy between January 2001 and December 2006 was analyzed. Spleen volume was calculated as length x width x depth from the pathologist's measurements.
LS was performed in 25 patients with a median age of 41 years (range = 24-65). OS was performed in 27 patients with a median age of 60 years (range = 24-86) (p < 0.001). Conversion to OS was necessary in two patients (8%). Operation time was significantly shorter in LS (p < 0.05). Spleen volume was significantly greater in patients who underwent open (median = 2520 ml, range = 150-16,800 ml) versus laparoscopic (median = 648 ml, range = 150-4860 ml) splenectomy (p = 0.001). In 36% of all laparoscopic procedures, spleen volume exceeded 1000 ml. The underlying disease was mainly immunothrombocytopenia in LS patients and lymphoma and osteomyelofibrosis in OS patients. Five patients died after OS. Significantly more patients were hospitalized longer than 7 days following OS than following LS (p < 0.05). Overall complication rate was higher after OS (LS, 8; OS, 13 patients; p < 0.05).
LS was preferred in younger patients with moderate splenomegaly, while massive splenomegaly mostly led to OS. In view of the absence of technique-related differences, LS can primarily be attempted in all patients.
Keywords
Adult, Aged, Aged, 80 and over, Cohort Studies, Elective Surgical Procedures, Female, Humans, Laparoscopy, Laparotomy, Length of Stay, Male, Middle Aged, Retrospective Studies, Splenectomy/adverse effects, Splenectomy/methods, Splenic Diseases/mortality, Splenic Diseases/pathology, Splenic Diseases/surgery, Treatment Outcome, Young Adult
Pubmed
Web of science
Create date
11/12/2018 15:18
Last modification date
20/08/2019 14:44
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