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Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases

Prediction of intraoperative difficulties may be helpful in planning surgery; however, few studies explored this issue in laparoscopic splenectomy (LS). We performed retrospective analysis of consecutive 468 patients undergoing LS from 1998 to 2017 (295 women; median age 47 years). The patients were...

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Autores principales: Wysocki, Michał, Radkowiak, Dorota, Zychowicz, Anna, Rubinkiewicz, Mateusz, Kulawik, Jan, Major, Piotr, Pędziwiatr, Michał, Budzyński, Andrzej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306709/
https://www.ncbi.nlm.nih.gov/pubmed/30558132
http://dx.doi.org/10.3390/jcm7120547
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author Wysocki, Michał
Radkowiak, Dorota
Zychowicz, Anna
Rubinkiewicz, Mateusz
Kulawik, Jan
Major, Piotr
Pędziwiatr, Michał
Budzyński, Andrzej
author_facet Wysocki, Michał
Radkowiak, Dorota
Zychowicz, Anna
Rubinkiewicz, Mateusz
Kulawik, Jan
Major, Piotr
Pędziwiatr, Michał
Budzyński, Andrzej
author_sort Wysocki, Michał
collection PubMed
description Prediction of intraoperative difficulties may be helpful in planning surgery; however, few studies explored this issue in laparoscopic splenectomy (LS). We performed retrospective analysis of consecutive 468 patients undergoing LS from 1998 to 2017 (295 women; median age 47 years). The patients were divided into difficult LS and control groups. The inclusion criteria for difficult LS were operative time ≥mean + 2SD; intraoperative blood loss ≥500 mL, intraoperative adverse events (IAE), conversion. Primary outcomes were risk factors for difficult splenectomy and secondary outcomes for perioperative morbidity. Fifty-six patients were included in the difficult LS group (12%). Spleens ≥19 cm and higher participation of younger surgeons in consecutive years were predictive for difficult splenectomy. Age ≥53 years and diagnosis other than idiopathic thrombocytopenic purpura (ITP) were independent risk factors of spleen ≥19 cm. The perioperative morbidity was 8.33%; its OR was increased only by blood loss and IAEs. Only blood loss significantly increased serious morbidity. Male sex, spleens ≥19 cm, and IAEs were independent risk factors for intraoperative hemorrhage. Spleen length ≥19 cm was a risk factor for difficult LS and intraoperative hemorrhage. Diagnoses other than ITP in patients aged ≥53 years with ≥19 cm spleens are predictive for intraoperative difficulties and perioperative complications.
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spelling pubmed-63067092019-01-02 Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases Wysocki, Michał Radkowiak, Dorota Zychowicz, Anna Rubinkiewicz, Mateusz Kulawik, Jan Major, Piotr Pędziwiatr, Michał Budzyński, Andrzej J Clin Med Article Prediction of intraoperative difficulties may be helpful in planning surgery; however, few studies explored this issue in laparoscopic splenectomy (LS). We performed retrospective analysis of consecutive 468 patients undergoing LS from 1998 to 2017 (295 women; median age 47 years). The patients were divided into difficult LS and control groups. The inclusion criteria for difficult LS were operative time ≥mean + 2SD; intraoperative blood loss ≥500 mL, intraoperative adverse events (IAE), conversion. Primary outcomes were risk factors for difficult splenectomy and secondary outcomes for perioperative morbidity. Fifty-six patients were included in the difficult LS group (12%). Spleens ≥19 cm and higher participation of younger surgeons in consecutive years were predictive for difficult splenectomy. Age ≥53 years and diagnosis other than idiopathic thrombocytopenic purpura (ITP) were independent risk factors of spleen ≥19 cm. The perioperative morbidity was 8.33%; its OR was increased only by blood loss and IAEs. Only blood loss significantly increased serious morbidity. Male sex, spleens ≥19 cm, and IAEs were independent risk factors for intraoperative hemorrhage. Spleen length ≥19 cm was a risk factor for difficult LS and intraoperative hemorrhage. Diagnoses other than ITP in patients aged ≥53 years with ≥19 cm spleens are predictive for intraoperative difficulties and perioperative complications. MDPI 2018-12-14 /pmc/articles/PMC6306709/ /pubmed/30558132 http://dx.doi.org/10.3390/jcm7120547 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wysocki, Michał
Radkowiak, Dorota
Zychowicz, Anna
Rubinkiewicz, Mateusz
Kulawik, Jan
Major, Piotr
Pędziwiatr, Michał
Budzyński, Andrzej
Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases
title Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases
title_full Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases
title_fullStr Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases
title_full_unstemmed Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases
title_short Prediction of Technical Difficulties in Laparoscopic Splenectomy and Analysis of Risk Factors for Postoperative Complications in 468 Cases
title_sort prediction of technical difficulties in laparoscopic splenectomy and analysis of risk factors for postoperative complications in 468 cases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306709/
https://www.ncbi.nlm.nih.gov/pubmed/30558132
http://dx.doi.org/10.3390/jcm7120547
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