Abstract
Background. Open surgery is the standard approach for splenectomy in hematologic disorders, but a few cases of successful laparoscopic splenectomy have been reported. Methods. Thirty-one patients (18 adults, group 1; and 13 children, group 2) underwent laparoscopic splenectomy. Indications for surgery, included idiopathic thrombocytopenic purpura (25 patients), congenital spherocytosis (4 patients), and hemolytic anemia (2 patients). In 97% of the patients the diameter of the spleen was less than 15 cm. Results. Laparoscopic splenectomy was successful in 94% of the patients; conversion to open surgery was mainly related to hemorrhage. Accessory spleen was found in 39% in group 1 and 8% in group 2. Two adults received intraoperative autotransfusion. Postoperative morbidity was minimal. The median postoperative stay was 3 days (range, 2 to 12 days) in group 1 and 2 days (range, 2 to 5 days) in group 2. Conclusions. Laparoscopic splenectomy is safe in both adults and children. Adequate selection of patients (small-size spleen, splenic destruction on preoperative scanning of platelets), appropriate preparation in patients with idiopathic thrombocytopenic purpura (immunoglobulin G), and meticulous surgical technique (with routine opening of the gastrocolic ligament to search for accessory spleen) are key factors in obtaining the same long-term results as with open surgery.
| Original language | English |
|---|---|
| Pages (from-to) | 384-389 |
| Number of pages | 6 |
| Journal | Surgery |
| Volume | 119 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 1996 |
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ASJC Scopus subject areas
- Surgery
Cite this
Laparoscopic splenectomy in adults and children : Experience with 31 patients. / Gigot, J. F.; De Goyet, J. D V; Van Beers, B. E.; Reding, R.; Etienne, J.; Jadoul, P.; Michaux, J. L.; Ferrant, A.; Cornu, G.; Otte, J. B.; Pringot, J.; Kestens, P. J.
In: Surgery, Vol. 119, No. 4, 1996, p. 384-389.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Laparoscopic splenectomy in adults and children
T2 - Experience with 31 patients
AU - Gigot, J. F.
AU - De Goyet, J. D V
AU - Van Beers, B. E.
AU - Reding, R.
AU - Etienne, J.
AU - Jadoul, P.
AU - Michaux, J. L.
AU - Ferrant, A.
AU - Cornu, G.
AU - Otte, J. B.
AU - Pringot, J.
AU - Kestens, P. J.
PY - 1996
Y1 - 1996
N2 - Background. Open surgery is the standard approach for splenectomy in hematologic disorders, but a few cases of successful laparoscopic splenectomy have been reported. Methods. Thirty-one patients (18 adults, group 1; and 13 children, group 2) underwent laparoscopic splenectomy. Indications for surgery, included idiopathic thrombocytopenic purpura (25 patients), congenital spherocytosis (4 patients), and hemolytic anemia (2 patients). In 97% of the patients the diameter of the spleen was less than 15 cm. Results. Laparoscopic splenectomy was successful in 94% of the patients; conversion to open surgery was mainly related to hemorrhage. Accessory spleen was found in 39% in group 1 and 8% in group 2. Two adults received intraoperative autotransfusion. Postoperative morbidity was minimal. The median postoperative stay was 3 days (range, 2 to 12 days) in group 1 and 2 days (range, 2 to 5 days) in group 2. Conclusions. Laparoscopic splenectomy is safe in both adults and children. Adequate selection of patients (small-size spleen, splenic destruction on preoperative scanning of platelets), appropriate preparation in patients with idiopathic thrombocytopenic purpura (immunoglobulin G), and meticulous surgical technique (with routine opening of the gastrocolic ligament to search for accessory spleen) are key factors in obtaining the same long-term results as with open surgery.
AB - Background. Open surgery is the standard approach for splenectomy in hematologic disorders, but a few cases of successful laparoscopic splenectomy have been reported. Methods. Thirty-one patients (18 adults, group 1; and 13 children, group 2) underwent laparoscopic splenectomy. Indications for surgery, included idiopathic thrombocytopenic purpura (25 patients), congenital spherocytosis (4 patients), and hemolytic anemia (2 patients). In 97% of the patients the diameter of the spleen was less than 15 cm. Results. Laparoscopic splenectomy was successful in 94% of the patients; conversion to open surgery was mainly related to hemorrhage. Accessory spleen was found in 39% in group 1 and 8% in group 2. Two adults received intraoperative autotransfusion. Postoperative morbidity was minimal. The median postoperative stay was 3 days (range, 2 to 12 days) in group 1 and 2 days (range, 2 to 5 days) in group 2. Conclusions. Laparoscopic splenectomy is safe in both adults and children. Adequate selection of patients (small-size spleen, splenic destruction on preoperative scanning of platelets), appropriate preparation in patients with idiopathic thrombocytopenic purpura (immunoglobulin G), and meticulous surgical technique (with routine opening of the gastrocolic ligament to search for accessory spleen) are key factors in obtaining the same long-term results as with open surgery.
UR - http://www.scopus.com/inward/record.url?scp=0029868122&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029868122&partnerID=8YFLogxK
U2 - 10.1016/S0039-6060(96)80136-X
DO - 10.1016/S0039-6060(96)80136-X
M3 - Article
C2 - 8644001
AN - SCOPUS:0029868122
VL - 119
SP - 384
EP - 389
JO - Surgery
JF - Surgery
SN - 0039-6060
IS - 4
ER -