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Massive Splenomegaly in Children: Laparoscopic Versus Open Splenectomy
BACKGROUND AND OBJECTIVES: Laparoscopic splenectomy for massive splenomegaly is still a controversial procedure as compared with open splenectomy. We aimed to compare the feasibility of laparoscopic splenectomy versus open splenectomy for massive splenomegaly from different surgical aspects in child...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Society of Laparoendoscopic Surgeons
2014
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154414/ https://www.ncbi.nlm.nih.gov/pubmed/25392624 http://dx.doi.org/10.4293/JSLS.2014.00245 |
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author | Hassan, Mohamed E. Al Ali, Khalid |
author_facet | Hassan, Mohamed E. Al Ali, Khalid |
author_sort | Hassan, Mohamed E. |
collection | PubMed |
description | BACKGROUND AND OBJECTIVES: Laparoscopic splenectomy for massive splenomegaly is still a controversial procedure as compared with open splenectomy. We aimed to compare the feasibility of laparoscopic splenectomy versus open splenectomy for massive splenomegaly from different surgical aspects in children. METHODS: The data of children aged <12 years with massive splenomegaly who underwent splenectomy for hematologic disorders were retrospectively reviewed in 2 pediatric surgery centers from June 2004 until July 2012. RESULTS: The study included 32 patients, 12 who underwent laparoscopic splenectomy versus 20 who underwent open splenectomy. The mean ages were 8.5 years and 8 years in the laparoscopic splenectomy group and open splenectomy group, respectively. The mean operative time was 180 minutes for laparoscopic splenectomy and 120 minutes for open splenectomy. The conversion rate was 8%. The mean amount of intraoperative blood loss was 60 mL in the laparoscopic splenectomy group versus 110 mL in the open splenectomy group. Postoperative atelectasis developed in 2 cases in the open splenectomy group (10%) and 1 case in the laparoscopic splenectomy group (8%). Oral feeding postoperatively resumed at a mean of 7.5 hours in the laparoscopic splenectomy group versus 30 hours in the open splenectomy group. The mean hospital stay was 36 hours in the laparoscopic splenectomy group versus 96 hours in the open splenectomy group. Postoperative pain was less in the laparoscopic splenectomy group. CONCLUSION: Laparoscopic splenectomy for massive splenomegaly in children is safe and feasible. Although the operative time was significantly greater in the laparoscopic splenectomy group, laparoscopic splenectomy was associated with statistically significantly less pain, less blood loss, better recovery, and shorter hospital stay. Laparoscopic splenectomy for pediatric hematologic disorders should be the gold-standard approach regardless of the size of the spleen. |
format | Online Article Text |
id | pubmed-4154414 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Society of Laparoendoscopic Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-41544142014-09-08 Massive Splenomegaly in Children: Laparoscopic Versus Open Splenectomy Hassan, Mohamed E. Al Ali, Khalid JSLS Scientific Papers BACKGROUND AND OBJECTIVES: Laparoscopic splenectomy for massive splenomegaly is still a controversial procedure as compared with open splenectomy. We aimed to compare the feasibility of laparoscopic splenectomy versus open splenectomy for massive splenomegaly from different surgical aspects in children. METHODS: The data of children aged <12 years with massive splenomegaly who underwent splenectomy for hematologic disorders were retrospectively reviewed in 2 pediatric surgery centers from June 2004 until July 2012. RESULTS: The study included 32 patients, 12 who underwent laparoscopic splenectomy versus 20 who underwent open splenectomy. The mean ages were 8.5 years and 8 years in the laparoscopic splenectomy group and open splenectomy group, respectively. The mean operative time was 180 minutes for laparoscopic splenectomy and 120 minutes for open splenectomy. The conversion rate was 8%. The mean amount of intraoperative blood loss was 60 mL in the laparoscopic splenectomy group versus 110 mL in the open splenectomy group. Postoperative atelectasis developed in 2 cases in the open splenectomy group (10%) and 1 case in the laparoscopic splenectomy group (8%). Oral feeding postoperatively resumed at a mean of 7.5 hours in the laparoscopic splenectomy group versus 30 hours in the open splenectomy group. The mean hospital stay was 36 hours in the laparoscopic splenectomy group versus 96 hours in the open splenectomy group. Postoperative pain was less in the laparoscopic splenectomy group. CONCLUSION: Laparoscopic splenectomy for massive splenomegaly in children is safe and feasible. Although the operative time was significantly greater in the laparoscopic splenectomy group, laparoscopic splenectomy was associated with statistically significantly less pain, less blood loss, better recovery, and shorter hospital stay. Laparoscopic splenectomy for pediatric hematologic disorders should be the gold-standard approach regardless of the size of the spleen. Society of Laparoendoscopic Surgeons 2014 /pmc/articles/PMC4154414/ /pubmed/25392624 http://dx.doi.org/10.4293/JSLS.2014.00245 Text en © 2014 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way. |
spellingShingle | Scientific Papers Hassan, Mohamed E. Al Ali, Khalid Massive Splenomegaly in Children: Laparoscopic Versus Open Splenectomy |
title | Massive Splenomegaly in Children: Laparoscopic Versus Open Splenectomy |
title_full | Massive Splenomegaly in Children: Laparoscopic Versus Open Splenectomy |
title_fullStr | Massive Splenomegaly in Children: Laparoscopic Versus Open Splenectomy |
title_full_unstemmed | Massive Splenomegaly in Children: Laparoscopic Versus Open Splenectomy |
title_short | Massive Splenomegaly in Children: Laparoscopic Versus Open Splenectomy |
title_sort | massive splenomegaly in children: laparoscopic versus open splenectomy |
topic | Scientific Papers |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154414/ https://www.ncbi.nlm.nih.gov/pubmed/25392624 http://dx.doi.org/10.4293/JSLS.2014.00245 |
work_keys_str_mv | AT hassanmohamede massivesplenomegalyinchildrenlaparoscopicversusopensplenectomy AT alalikhalid massivesplenomegalyinchildrenlaparoscopicversusopensplenectomy |