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Feasibility and Safety of Laparoscopic Partial Splenectomy: A Systematic Review

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Abstract

Background

Laparoscopic partial splenectomy (LPS) is a challenging procedure. The aim of this review was to evaluate its feasibility, safety, and potential benefits.

Methods

We conducted a comprehensive review for the years 1995–2018 to retrieve all relevant articles.

Results

A total of 44 studies with 252 patients undergoing LPS were reviewed. Six studies described combined operations. Ranges of operative time and estimated blood loss were 50–225 min and 0–1200 ml, respectively. There are eight patients need blood transfusion in 231 patients with available data. The conversion rate was 3.6% (9/252). Overall, 27 patients (10.7%;27/252) developed postoperative or intraoperative complications. Overall mortality was 0% (0/252). The length of postoperative stay (POS) varied (1–11 days). Among four comparative studies, one showed LPS could reduce POS than laparoscopic total splenectomy (LTS) (LTS 5.4 ± 1.8 days, LPS 4.2 ± 0.8 days, p = 0.027) and complications (pleural effusion (LTS 9/22, LPS 0/15, p = 0.005), splenic vein thrombosis (LTS 10/22, LPS 0/15, p = 0.002)). Another comparative study showed LPS may benefit emergency patients. However, one comparative study showed LPS was associated with more pain, longer time to oral intake, and longer POS in children with hereditary spherocytosis. The fourth comparative study showed robotic subtotal splenectomy was comparable to laparoscopy in terms of POS and complication. The main benefits were lower blood loss, vascular dissection time, and a better evaluation of splenic remnant volume.

Conclusions

In early series of highly selected patients, LPS appears to be feasible and safe when performed by experienced laparoscopic surgeons.

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Acknowledgement

Gangshan Liu contributed to literature research and manuscript preparation. Ying Fan contributed to literature research and approved the final version of manuscript.

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Authors and Affiliations

  1. Department of the Second General Surgery, Sheng Jing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang City, Liaoning Province, China

    Gangshan Liu & Ying Fan

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Correspondence to Ying Fan.

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Dr. Liu and Dr. Fan have no conflicts of interest or financial ties to disclose. Informed consent was obtained from all individual participants included in this review.

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Liu, G., Fan, Y. Feasibility and Safety of Laparoscopic Partial Splenectomy: A Systematic Review. World J Surg 43, 1505–1518 (2019). https://doi.org/10.1007/s00268-019-04946-8

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