Abstract
Objective: To identify predictive risk factors for conversion to open splenectomy and postoperative complications in patients undergoing elective laparoscopic splenectomy. Background: The laparoscopic approach represents the "gold standard" for splenectomy, but its use in the treatment of splenomegaly and malignant disease is controversial. Factors that influence immediate outcome are clinical, anatomic, and pathologic. Methods: Univariate and multivariate analyses of data from the Italian Registry of Laparoscopic Surgery of the Spleen, a multicenter database supported by 25 referral centers. Analysis of data (1993-2007) was performed on a series of patients (n = 676) undergoing elective laparoscopic splenectomy. Demographic data, the operative indications, the surgical technique applied, and any intra-and/or postoperative complications with respect to the patients were assessed. Records were analyzed retrospectively using the Student t test, the χ test, and logistic regression. Results: Conversion to open splenectomy was necessary in 39 cases (5.8%). Perioperative deaths occurred in 3 cases (0.4%). There were no complications in 560 patients (82.8%), with a mean hospital stay of 5 days (range, 2-54). Overall, morbidity occurred in 116 patients (17.2%). Multivariate analysis found that the body mass index (P = 0.01) and the presence of hematologic malignancy (P <0.001) were independent predictors for intraoperative complications and surgical conversion. Spleen longitudinal diameter (P = 0.001) and surgical conversion (P = 0.001) were independent predictors for the occurrence of postoperative complications. Conclusions: This large multicenter study provides evidence for the significance of predictive risk factors for intra-and postoperative complications in laparoscopic splenic surgery. Besides splenic dimensions, other factors like the patient's habitus and the specific underlying hematologic pathology should be recognized by the surgeon to reduce complications and initiate adequate treatment.
| Original language | English |
|---|---|
| Pages (from-to) | 287-291 |
| Number of pages | 5 |
| Journal | Annals of Surgery |
| Volume | 251 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 2010 |
Fingerprint
ASJC Scopus subject areas
- Surgery
Cite this
Putative predictive parameters for the outcome of laparoscopic splenectomy : A multicenter analysis performed on the italian registry of laparoscopic surgery of the spleen. / Casaccia, Marco; Torelli, Paolo; Pasa, Ambra; Sormani, Maria Pia; Rossi, Edoardo.
In: Annals of Surgery, Vol. 251, No. 2, 02.2010, p. 287-291.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Putative predictive parameters for the outcome of laparoscopic splenectomy
T2 - A multicenter analysis performed on the italian registry of laparoscopic surgery of the spleen
AU - Casaccia, Marco
AU - Torelli, Paolo
AU - Pasa, Ambra
AU - Sormani, Maria Pia
AU - Rossi, Edoardo
PY - 2010/2
Y1 - 2010/2
N2 - Objective: To identify predictive risk factors for conversion to open splenectomy and postoperative complications in patients undergoing elective laparoscopic splenectomy. Background: The laparoscopic approach represents the "gold standard" for splenectomy, but its use in the treatment of splenomegaly and malignant disease is controversial. Factors that influence immediate outcome are clinical, anatomic, and pathologic. Methods: Univariate and multivariate analyses of data from the Italian Registry of Laparoscopic Surgery of the Spleen, a multicenter database supported by 25 referral centers. Analysis of data (1993-2007) was performed on a series of patients (n = 676) undergoing elective laparoscopic splenectomy. Demographic data, the operative indications, the surgical technique applied, and any intra-and/or postoperative complications with respect to the patients were assessed. Records were analyzed retrospectively using the Student t test, the χ test, and logistic regression. Results: Conversion to open splenectomy was necessary in 39 cases (5.8%). Perioperative deaths occurred in 3 cases (0.4%). There were no complications in 560 patients (82.8%), with a mean hospital stay of 5 days (range, 2-54). Overall, morbidity occurred in 116 patients (17.2%). Multivariate analysis found that the body mass index (P = 0.01) and the presence of hematologic malignancy (P <0.001) were independent predictors for intraoperative complications and surgical conversion. Spleen longitudinal diameter (P = 0.001) and surgical conversion (P = 0.001) were independent predictors for the occurrence of postoperative complications. Conclusions: This large multicenter study provides evidence for the significance of predictive risk factors for intra-and postoperative complications in laparoscopic splenic surgery. Besides splenic dimensions, other factors like the patient's habitus and the specific underlying hematologic pathology should be recognized by the surgeon to reduce complications and initiate adequate treatment.
AB - Objective: To identify predictive risk factors for conversion to open splenectomy and postoperative complications in patients undergoing elective laparoscopic splenectomy. Background: The laparoscopic approach represents the "gold standard" for splenectomy, but its use in the treatment of splenomegaly and malignant disease is controversial. Factors that influence immediate outcome are clinical, anatomic, and pathologic. Methods: Univariate and multivariate analyses of data from the Italian Registry of Laparoscopic Surgery of the Spleen, a multicenter database supported by 25 referral centers. Analysis of data (1993-2007) was performed on a series of patients (n = 676) undergoing elective laparoscopic splenectomy. Demographic data, the operative indications, the surgical technique applied, and any intra-and/or postoperative complications with respect to the patients were assessed. Records were analyzed retrospectively using the Student t test, the χ test, and logistic regression. Results: Conversion to open splenectomy was necessary in 39 cases (5.8%). Perioperative deaths occurred in 3 cases (0.4%). There were no complications in 560 patients (82.8%), with a mean hospital stay of 5 days (range, 2-54). Overall, morbidity occurred in 116 patients (17.2%). Multivariate analysis found that the body mass index (P = 0.01) and the presence of hematologic malignancy (P <0.001) were independent predictors for intraoperative complications and surgical conversion. Spleen longitudinal diameter (P = 0.001) and surgical conversion (P = 0.001) were independent predictors for the occurrence of postoperative complications. Conclusions: This large multicenter study provides evidence for the significance of predictive risk factors for intra-and postoperative complications in laparoscopic splenic surgery. Besides splenic dimensions, other factors like the patient's habitus and the specific underlying hematologic pathology should be recognized by the surgeon to reduce complications and initiate adequate treatment.
UR - http://www.scopus.com/inward/record.url?scp=77449159141&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77449159141&partnerID=8YFLogxK
U2 - 10.1097/SLA.0b013e3181bfda59
DO - 10.1097/SLA.0b013e3181bfda59
M3 - Article
C2 - 20010087
AN - SCOPUS:77449159141
VL - 251
SP - 287
EP - 291
JO - Annals of Surgery
JF - Annals of Surgery
SN - 0003-4932
IS - 2
ER -