Laparoscopic splenectomy in adults and children: Experience with 31 patients

J. F. Gigot, J. D V De Goyet, B. E. Van Beers, R. Reding, J. Etienne, P. Jadoul, J. L. Michaux, A. Ferrant, G. Cornu, J. B. Otte, J. Pringot, P. J. Kestens

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)384-389
Number of pages6
JournalSurgery
Volume119
Issue number4
DOIs
Publication statusPublished - 1996

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Splenectomy
Spleen
Idiopathic Thrombocytopenic Purpura
Conversion to Open Surgery
Autologous Blood Transfusions
Hemolytic Anemia
Ligaments
Patient Selection
Blood Platelets
Immunoglobulin G
Hemorrhage
Morbidity

ASJC Scopus subject areas

  • Surgery

Cite this

Gigot, J. F., De Goyet, J. D. V., Van Beers, B. E., Reding, R., Etienne, J., Jadoul, P., ... Kestens, P. J. (1996). Laparoscopic splenectomy in adults and children: Experience with 31 patients. Surgery, 119(4), 384-389. https://doi.org/10.1016/S0039-6060(96)80136-X

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 journalArticle

Gigot, JF, De Goyet, JDV, Van Beers, BE, Reding, R, Etienne, J, Jadoul, P, Michaux, JL, Ferrant, A, Cornu, G, Otte, JB, Pringot, J & Kestens, PJ 1996, 'Laparoscopic splenectomy in adults and children: Experience with 31 patients', Surgery, vol. 119, no. 4, pp. 384-389. https://doi.org/10.1016/S0039-6060(96)80136-X
Gigot JF, De Goyet JDV, Van Beers BE, Reding R, Etienne J, Jadoul P et al. Laparoscopic splenectomy in adults and children: Experience with 31 patients. Surgery. 1996;119(4):384-389. https://doi.org/10.1016/S0039-6060(96)80136-X
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. / Laparoscopic splenectomy in adults and children : Experience with 31 patients. In: Surgery. 1996 ; Vol. 119, No. 4. pp. 384-389.
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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.",
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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.

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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.

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