The impact of splenic weight on laparoscopic splenectomy for splenomegaly

Abstract

Background: Enlarged spleens increase the technical difficulties associated with laparoscopic splenectomy (LS). The aim of this study was to analyze the impact of splenic weight on the results of LS. Methods: We performed a prospective analysis of 20 LS for splenomegaly and 40 LS for normal spleen in terms of intraoperative and early postoperative outcome. Results: Patients with splenomegaly had longer operative times and higher conversion and transfusion rates than those with normal spleens. Patients with spleens weighing < 2000 G EXPERIENCED LESS BLOOD LOSS, FEWER CONVERSIONS, AND A SHORTER POSTOPERATIVE HOSPITAL STAY THAN THOSE WITH SPLEENS > 2000 g. No differences-except for the longer operative time-were observed between normal-sized spleens and those weighing < 2000 G. CONCLUSIONS: LS FOR SPLENOMEGALY IS FEASIBLE FOR EXPERIENCED LAPAROSCOPIC SURGEONS. FOR SPLEENS WEIGHING < 2000 G, THE OUTCOME WAS COMPARABLE TO THAT OF NORMAL SPLEENS, WHEREAS LS FOR SPLEENS >2000 g was associated with a higher conversion rate, greater blood loss, a longer hospital stay, and increased morbidity.