Is Laparoscopic splenectomy a justified approach in hematologic disorders? Preliminary results of a prospective multicenter study

J. F. Gigot, M. Legrand, G. B. Cadiere, G. Delvaux, J. De Ville de Goyet, A. De Neve de Roden, E. Van Vyve, P. Hourlay, J. Etienne, B. Njinou, A. Collard

Research output: Contribution to journalArticle

Abstract

The feasibility and safety of laparoscopic splenectomy were evaluated in a prospective multicenter study of 50 patients operated on for idiopathic thrombocytopenic purpura (ITP) (n = 31), hereditary spherocytosis (n = 6), hemolytic anemia (n = 4), Hodgkin's disease or lymphoma staging (n = 5), benign splenic tumors (n = 3), and wandering spleen (n = 1). Conversion to laparotomy was required in 10%. An accessory spleen was routinely searched for, although the lesser sac was opened during surgery in only 10%; the overall incidence was 14%. Hospital mortality was 2% and postoperative morbidity 22%. Postoperative hospital stay and home rehabilitation were improved when exclusively laparoscopic splenectomy was performed. In ITP patients, at a mean follow-up of 8.2 months, 8 patients (27%) had recurrence of thrombocytopenia, which was transient in 7% and permanent in 20%. Laparoscopic splenectomy is feasible and safe when performed in selected patients by expert laparoscopic surgeons. Adequate selection of patients and routine, careful search for accessory spleen are critical. The recurrence rate (20%) for ITP was high at 8.2 months, and this factor is the major limitation of laparoscopic splenectomy at present.

Original languageEnglish
Pages (from-to)299-303
Number of pages5
JournalInternational Surgery
Volume80
Issue number4
Publication statusPublished - 1995

Keywords

  • Accessory spleen
  • Idiopathic thrombocytopenic purpura
  • Recurrence
  • Spherocytosis
  • Splenectomy, laparoscopic

ASJC Scopus subject areas

  • Surgery

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  • Cite this

    Gigot, J. F., Legrand, M., Cadiere, G. B., Delvaux, G., De Ville de Goyet, J., De Neve de Roden, A., Van Vyve, E., Hourlay, P., Etienne, J., Njinou, B., & Collard, A. (1995). Is Laparoscopic splenectomy a justified approach in hematologic disorders? Preliminary results of a prospective multicenter study. International Surgery, 80(4), 299-303.