Early Experience with Laparoscopic Splenectomy in Benign Splenic Disorders
Journal of Surgery
Volume 5, Issue 3-1, May 2017, Pages: 70-75
Received: Mar. 15, 2017; Accepted: Mar. 16, 2017; Published: Mar. 31, 2017
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Taha Ahmed Esmail, Department of General Surgery, Tanta University, Tanta, Egypt
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Background: Laparoscopic splenectomy is evolving procedure and is now considered the procedure of choice in elective splenectomy by many centers, but technically demanding especially in large sized ones. Our aim was to evaluate the outcome of laparoscopic splenectomy for a variety of benign splenic disorders in our early experience. Patients and Methods: This prospective study was carried out on twenty-two patients treated with laparoscopic splenectomy in Tanta University Hospital from January 2014 to January 2016. Patients chart review including patient characteristics, splenic pathology, intraoperative difficulties or complications and postoperative outcome. Follow up ranged from 6 months to 2 years with a mean of 20 months. Results: Age of patients ranged from fifteen to fifty-nine years with a mean of 41.7 years. Fourteen cases (63%) with idiopathic thrombocytopenic purpura (ITP), six cases (27.3%) with hypersplenism and two cases (9.1%) with autoimmune hemolytic anemia. Accessory spleens were found in six patients (27.3%) and removed. Mean operative time was 120±15 minutes. Intraoperative bleeding occurred in six cases (27.3%), laparoscopic control attempted and succeeded in four of them, but conversion was inevitable in two cases (9.1%). There were no major postoperative complications or deaths. Conclusion: Laparoscopic splenectomy is not only safe minimal invasive procedure, with comparable results of the open splenectomy in management of small and medium sized spleens but also, has the advantages of negligible intraoperative blood loss. Larger series with longer periods of follow up are required to evaluate this promising operation.
Laparoscopic Splenectomy, Purpura, Idiopathic Thrombocytopenic, Hypersplenism
To cite this article
Taha Ahmed Esmail, Early Experience with Laparoscopic Splenectomy in Benign Splenic Disorders, Journal of Surgery. Special Issue: Minimally Invasive and Minimally Access Surgery. Vol. 5, No. 3-1, 2017, pp. 70-75. doi: 10.11648/j.js.s.2017050301.23
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Bernardino C. Branco I. Anrew L. et al. Selective nonoperative management of high grade splenic trauma. Rev. Col. Bras. Cir. 2013, 40 (3): 246-250.
Aksnes JAbdelnoor MMathisen O Risk factors associated with mortality and morbidity after elective splenectomy. Eur J Surg. 1995, 161253-258
Horowitz JSmith JLWeber TKRodriguez-Bigas MAPetrelli NJ Postoperative complications after splenectomy for hematologic malignancies. Ann Surg. 1996, 223290-296.
Wheatley TJ, Johnstone JMS et al. Laparoscopic splenectomy: a suitable technique for children and adults. BJS 2000, 87 (3): 462.
Delaitre B. Maignien B. and Icard PH. Laparoscopi c splenectomy. BJSurg.1992, 97: 1334.
Alfons Pomp, Michel Gagner, et al, Laparoscopic Splenectomy: A Selected Retrospective Review. Surg Laparosc Endosc Percutan Tech 2005, 15(3): 73-77.
Vecchio R, Marchese S. et al. Long-term results after splenectomy in adult idiopathic thrombocytopenic purpura: comparison between open and laparoscopic procedures. J Laparoendosc Adv Surg Tech A 2013, 23 (3): 192–198.
K¨uhne T, Blanchette V. et al. Splenectomy in children with idiopathic thrombocytopenic purpura: a prospective study of 134 children from the Intercontinental Childhood ITP Study Group. Pediatr Blood Cancer 2007, 49 (6): 829–883.
Qu Y, Ren S, Li C, Qian S, Liu P. Management of postoperative complications following splenectomy. Int Surg 2013; 98 (1): 55–60.
Gagner M, Lacroix A, Prinz RA, et aI. Early experience with laparoscopic approach for adrenalectomy. Surgery 1993, 114: 1120-1123.
Yikun Qu1, Jian Xu1. Et al. Long-Term Outcomes of Laparoscopic Splenectomy Versus Open Splenectomy for Idiopathic Thrombocytopenic Purpura Int Surg 2014, 99: 286–290.
Wang Y, Zhan X, Zhu Y, Xie Z, Zhu J, Ye Z. Laparoscopic splenectomy in portal hypertension: a single-surgeon 13-year experience. Surg Endosc. 2010; 24: 1164-1169.
Brunt LM, Langer JC, Quasebarth MA, et al. Comparative analysis of laparoscopic versus open splenectomy. Am J Surg. 1996, 172: 596-601.
Chia-Hung Su, Tzu-Cheih Yin et al. Laparoscopic splenectomy for splenomegaly using Homemade retrieval bag. Wideochir Inne Tech Maloinwazyjne 2013, 8 (4): 327-333.
Mohan Ramalingam et al. Transvaginal specimen extraction after combined laparoscopic splenectomy and hysterectomy: Introduction to NOSE (Natural Orifice Specimen Extraction) in a community hospital. International Journal of Surgery Case Reports 2013, 4 (12): 1138–1141.
Hashizume M, Tanoue K, Akahoshi T. Laparoscopic splenectomy: the latest modern technique. Hepatogastroenterology. 1999, 46: 820-824.
Mahon D, Rhodes M. Laparoscopic splenectomy: size matters. Ann R Coll Surg Engl. 2003, 85: 248-251.
Gajbhiye AS, Sunil ML, et al. Laparoscopic splenectomy: Review article. International JS 2015, 2 (2): 130-140.
Delaitre B, Champault G, Barrat C, et aI. Laparoscopic splenectomy for hematologic diseases. Study of 275 cases. French Society of Laparoscopic Surgery. Ann Chir. 2000, 125: 522-529.
Valentina G, RosaR et al. efficacy and safety of splenectomy in adult autoimmune hemolytic anemia Open Med. 2016,11:374-380.
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