Abstract
Background
Laparoscopic splenectomy is currently the procedure of choice for elective splenectomy. This study reviews the initial 100 laparoscopic splenectomies completed at the Cleveland Clinic Foundation.
Methods
A retrospective review of elective laparoscopic splenectomy was performed to assess clinical outcomes at the Cleveland Clinic Foundation. Patient demographics, preoperative diagnoses, operative characteristics, morbidity, and mortality were evaluated.
Results
Of the 169 elective splenectomies completed over a 4-year period from 1995 to 1999, 100 were attempted laparoscopically. The proportions of all splenectomies attempted laparoscopically by year were 17%, 38%, 75%, and 72%. Nearly 70% of splenectomies were performed for idiopathic thrombocytopenic purpura or malignancy. Overall, the mean blood loss was 181 ml, and the mean operative time was 170 min. Splenomegaly occurred in 31% of the patients and accounted for longer operative times. Three patients required conversion to an open procedure. Postoperative complications were seen in 13% of the patients. One patient died in the postoperative period from staphylococcal sepsis, giving a mortality rate of 1%.
Conclusions
Laparoscopic splenectomy currently is the procedure of choice for elective splenectomy at our institution. As compared with traditional open splenectomy, laparoscopic splenectomy results in minimal morbidity even in the setting of splenomegaly.
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References
Akwari OE, Itani KMF, Coleman RE, Rosse WE (1987) Splenectomy for primary and recurrent immune thrombocytopenic purpura. Ann Surg 206: 529–539
Decker G, Millat B, Guillon F, Atger J, Linon M (1998) Laparoscopic splenectomy for benign and malignant hematologic diseases: 35 consecutive cases. World J Surg 22: 62–68
Delaitre B, Maignien B (1992) Laparoscopic splenectomy: technical aspects. Surg Endosc 6: 305–308
Friedman RL, Fallas MJ, Carroll BJ, Hiatt JR, Phillips EH (1996) Laparoscopic splenectomy for ITP: the gold standard. Surg Endosc 10: 991–995
Gigot JF, Healy ML, Ferrant A, Michaux JL, Njinou B, Kestens PJ (1994) Laparoscopic splenectomy for idiopathic thrombocytopenic purpura. Br J Surg 81: 1171–1172
Gigot JF, Jamar F, Ferrant A, van Beers BG, Lengele B, Pauwels S, Pringot J, Kestens PJ, Giarello P, Detry R (1988) Inadequete detection of accessory spleens and splenosis with laparoscopic splenectomy: a shortcoming of the laparoscopic approach in hematologic disease. Surg Endosc 12: 101–106
Lefor AT, Flowers JL, Heyman MR (1993) Laparoscopic staging of Hodgkin’s disease. Surg Oncol 2: 217–220
Phillips E, Carroll B, Fallas M (1994) Laparoscopic splenectomy. Surgical Endosc 8: 931–933
Poulin E, Thibault C, Mamazza J, Girotti M, Cote G, Renaud A (1993) Laparoscopic splenectomy: clinical experience and the role of preoperative splenic artery embolization. Surg Laparos Endosc 3: 445–450
Schlinkert RT, Mann D (1995) Laparoscopic splenectomy offers advantages in selected patients with idiopathic thrombocytopenic purpura. Am J Surg 170: 624–662
Thibault C, Mamazza J, Letoumeau R, Poulin E (1992) Laparoscopic splenectomy: operative technique and preliminary report. Surg Laparosc Endosc 2: 248–253
Trias M, Targarona EM, Espert JJ, Balague C (1998) Laparoscopic surgery for splenic disorders: lessons learned from a series of 64 cases. Surg Endosc 12: 66–72
Wani NA, Parray FQ (2000) Therapeutic splenectomy in immune thrombocytopenic purpura. World J Surg 24: 92–94
Watson DI, Coventry BJ, Chin T, Gill PG, Malycha P (1997) Laparoscopic versus open splenectomy for immune thrombocytopenic purpura. Surgery 121: 18–22
Winde G, Schmid KW, Lugering N, Fischer R, Brandt B, Berns T, Bunte H (1996) Results and prognostic factors of splenectomy in idiopathic thrombocytopenic purpura. J Am Coll Surg 183: 565–574
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Online publication: 8 February 2002
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Brodsky, J.A., Brody, F.J., Walsh, R.M. et al. Laparoscopic splenectomy. Surg Endosc 16, 851–854 (2002). https://doi.org/10.1007/s004640080095
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DOI: https://doi.org/10.1007/s004640080095