Abstract
To determine the safety and efficiacy of laparoscopic splenectomy (LS) in children, a retrospective review of our preliminary experience using LS was compared to results in patients who previously underwent open splenectomy (OS). From July 1993 to January 1995, we performed eight LS procedures in six children with hereditary spherocytosis (HS) and two with immune thrombocytopenic purpura (ITP). Laparoscopic cholecystectomy was simultaneously done in one case with HS. There were 4 males and 4 females who ranged in age from 5 to 15 years—an average age of 8.8 years. Two cases in the early series required a counterincision because of bleeding. Eleven patients who previously underwent OS in our department were used to compare demographics, operative courses, and surgical outcomes. The ages, genders, diseases, body weights, and spleen weights were comparable between LS group and OS groups. The operative time for the LS group was statistically longer than for the OS group (226±24 min vs 101±8 min, P<0.001). The estimated blood loss in the LS group was similar to that of the OS group (100±39 ml vs 73±11 ml, P=0.97). There were no peri- or postoperative complications in two groups. The postoperative hospital stay of LS group was statistically shorter than that of the OS (6.8±0.6 days vs 10.4±0.5 days, P<0.001). LS provided better cosmesis and minimized trauma in children over OS. LS appears to be a safe and effective procedure in children, and is useful in the management of pediatric patients with HS or ITP.
Similar content being viewed by others
References
Baesl TJ, Filler RM (1985) Surgical disease of the spleen. Surg Clin North Am 65: 1269–1286
Carroll B, Phillips E (1991) Laparoscopic splenectomy. Surg Endosc 6: 183–185
Cuschieri A, Shimi S, Banting S, Vander Valpen G (1992) Technical aspects of laparoscopic splenectomy: hilar segmental devascularization and instrumentation. J R Coll Surg Edinb 37: 414–416
Davis PW, Williams DA, Shamberger RC (1991) Immune thrombocytopenia: surgical therapy and predictor of response. J Pediatr Surg 26: 407–413
Frazee RC, Roberts JW, Okeson GC, Symmonds RE, Snyder SK, Hendricks JC, Smith RW (1991) Open versus laparoscopic cholecystectomy: A comparison of postoperative pulmonary function. Ann Surg 213: 651–654
Hashizume M, Sugimachi K, Kitano S, Shimada M, Baba H, Ueno K, Ohta M, Tomikawa M (1994) Laparoscopic splenectomy. Am J Surg 167: 611–614
Hashizume M, Sugimachi K, Ueno K (1992) Laparoscopic splenectomy with an ultrasonic dissector. N Engl J Med 324: 438
Hayhoe FG, Whitby L (1955) Splenic function: a study of the rationale and results of splenectomy in blood disorders. Am J Med 24:356–391
Lefor AT, Melvin WS, Bailey RW, Flowers JL (1993) Laparoscopic splenectomy in the management of immune thrombocytopenia purpura. Surgery 114: 613–618
Marble K, Deckers PJ, Kern KA (1992) Changing role of splenectomy for hematologic disease. Society of Surgical Oncology Meeting Abstract, New York, p 243
Sackier JM, Berci G (1990) Diagnostic and interventional laparoscopy for the general surgeon. Contemp Surg 37: 15–26
Smith BM, Schropp KP, Lobe TE, Rogers DA, Presbury GJ, Wilimas JA, Wong WC (1994) Laparoscopic splenectomy in childhood. J Pediatr Surg 29: 975–977
Thibault C, Mamazza J, Letourneau R, Poulin E (1992) Laparoscopic splenectomy: operative technique and preliminary report. Surg Laparosc Endosc 2: 257–261
Tulman S, Holcomb GW III, Karamanoukian HL, Reyhout J (1993) Pediatric laparoscopic splenectomy. J Pediatr Surg 28: 689–692
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yoshida, K., Yamazaki, Y., Mizuno, R. et al. Laparoscopic splenectomy in children. Surg Endosc 9, 1279–1282 (1995). https://doi.org/10.1007/BF00190159
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00190159