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Laparoscopic Partial Splenectomy: Indications and results of a multicenter retrospective study

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Abstract

Introduction

Partial splenectomy (PS) in children is a surgical option in haematological diseases and focal splenic tumours. The aim of this study was to describe the feasibility and the results of laparoscopic partial splenectomy in children in these two indications by a multicentric retrospective study.

Methods

The authors reviewed the files of all children who underwent laparoscopic PS between March 2002 and September 2006 in two paediatric surgical centers. The data of 11 children were collected and included clinical presentation, age, gender, radiographic examinations, surgical procedure, need for blood transfusion and early complications.

Results

From March 2002 to September 2006, laparoscopic PS had been performed on 11 children (6 boys, 5 girls) aged 23 months to 11 years (mean 7, 9). Four children had splenic focal tumours and seven had haematological diseases: six hereditary spherocytosis (HS) and one hemoglobinosis E. During the surgical procedure for haematological diseases 75–80% of the splenic tissue was removed. When PS was performed for focal splenic tumours, the splenic remnant was around 70%. No preoperative complications occurred (no bleeding, no diaphragmatic injury). Neither preoperative nor conversion was necessary. One postoperative complication occurred (left pleural effusion) but required no further treatment. The mean hospital stay was 7.7 days (range from 3 days to 10 days). No infectious postoperative complications occurred; the mean follow up was 21.1 months (range 3–52 months).

Conclusion

Laparoscopic partial splenectomy is feasible and safe in children with hypersplenism or focal splenic tumours. Partial splenectomy is a good way to prevent postsplenectomy infections by preservation of the immune role of spleen in children with haematological diseases. This technique performed for focal splenic tumours allows the surgeon to choose the size of the splenic remnant.

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Authors and Affiliations

  1. Dept of pediatric surgery, Hopital Timone Enfant, Marseille, France

    Géraldine Héry, Jean-Michel Guys & Pascal de Lagausie

  2. Dept. of Pediatric Surgery, Univ. Hospital of Strasbourg, Strasbourg, France

    François Becmeur & Laure Méfat

  3. Dept. of pediatric surgery, Hôpital Timone Enfant, Marseille, France

    David Kalfa

  4. Department of Oncological and Haematological diseases in children, Univ. Hospital of Strasbourg, Strasbourg, France

    Patrick Lutz & Laurence Lutz

Authors
  1. Géraldine Héry
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  2. François Becmeur
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  3. Laure Méfat
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  4. David Kalfa
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  5. Patrick Lutz
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  6. Laurence Lutz
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  7. Jean-Michel Guys
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  8. Pascal de Lagausie
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Correspondence to Géraldine Héry.

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Héry, G., Becmeur, F., Méfat, L. et al. Laparoscopic Partial Splenectomy: Indications and results of a multicenter retrospective study. Surg Endosc 22, 45–49 (2008). https://doi.org/10.1007/s00464-007-9509-0

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  • DOI: https://doi.org/10.1007/s00464-007-9509-0

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