J Korean Surg Soc.  2013 Jan;84(1):38-42.

Outcomes of laparoscopic versus open splenectomy

• Bulus H
• Mahmoud H
• Altun H
• Tas A
• Karayalcin K

Abstract

PURPOSE
Laparoscopic techniques have gained wide clinical acceptance in surgical practice today. The laparoscopic approach has been established as the technique of choice for elective splenectomies performed on normal sized spleens. The purpose of this study was to evaluate the outcome of patients undergoing laparoscopic splenectomy (LS) at the TOBB University of Economics and Technology (ETU) Hospital and Kecioren Training and Research Hospital.
METHODS
One hundred and thirty-five patients underwent splenectomy between January 2000 and July 2010. For comparison, the records of 130 patients undergoing splenectomy were evaluated for age, gender, hospital stay, time to start of diet, conversion rate, operation time and wound infection.
RESULTS
Mean operation time means the time interval between surgeon commencing operation to end of operation. Mean operation time in patients treated by LS was 132 minutes and 121 minutes in open splenectomy (OS). Mean hospital stay was 5.65 days in patients undergoing LS and starting of diet was 1.21 days. In patients treated by OS, mean hospital stay was 9.17 days, starting of diet was 2.37 days. Four patients were converted to open surgery. Conversion rate was 6.4 percent. In the early post operative period (within 10 days of surgery) 9.2%, LS group had lower incidences of wound infection rate after surgery than OS group (4.8%, 7.4%, respectively; P = 0.06).
CONCLUSION
LS is a safe and effective alternative to OS for treatment of splenic diseases in patients of all ages.

Keyword

Laparoscopy; Splenectomy

MeSH Terms

Diet
Humans
Incidence
Laparoscopy
Length of Stay
Spleen
Splenectomy
Splenic Diseases
Wound Infection

Reference

1. Glasgow RE, Yee LF, Mulvihill SJ. Laparoscopic splenectomy. The emerging standard. Surg Endosc. 1997. 11:108–112.

2. Delaitre B, Maignien B. Splenectomy by the laparoscopic approach. Report of a case. Presse Med. 1991. 20:2263.

3. Hashizume M, Sugimachi K, Ueno K. Laparoscopic splenectomy with an ultrasonic dissector. N Engl J Med. 1992. 327:438.

4. Glasgow RE, Mulvihill SJ. Laparoscopic splenectomy. World J Surg. 1999. 23:384–388.

5. Tsiotos G, Schlinkert RT. Laparoscopic splenectomy for immune thrombocytopenic purpura. Arch Surg. 1997. 132:642–646.

6. Watson DI, Coventry BJ, Chin T, Gill PG, Malycha P. Laparoscopic versus open splenectomy for immune thrombocytopenic purpura. Surgery. 1997. 121:18–22.

7. Brunt LM, Langer JC, Quasebarth MA, Whitman ED. Comparative analysis of laparoscopic versus open splenectomy. Am J Surg. 1996. 172:596–599.

8. Delaitre B, Pitre J. Laparoscopic splenectomy versus open splenectomy: a comparative study. Hepatogastroenterology. 1997. 44:45–49.

9. Winslow ER, Brunt LM. Perioperative outcomes of laparoscopic versus open splenectomy: a meta-analysis with an emphasis on complications. Surgery. 2003. 134:647–653.

10. Diaz J, Eisenstat M, Chung R. A case-controlled study of laparoscopic splenectomy. Am J Surg. 1997. 173:348–350.

11. Smith CD, Meyer TA, Goretsky MJ, Hyams D, Luchette FA, Fegelman EJ, et al. Laparoscopic splenectomy by the lateral approach: a safe and effective alternative to open splenectomy for hematologic diseases. Surgery. 1996. 120:789–794.

12. Olsen WR, Beaudoin DE. Increased incidence of accessory spleens in hematologic disease. Arch Surg. 1969. 98:762–763.

13. Janu PG, Rogers DA, Lobe TE. A comparison of laparoscopic and traditional open splenectomy in childhood. J Pediatr Surg. 1996. 31:109–113.

14. Donini A, Baccarani U, Terrosu G, Corno V, Ermacora A, Pasqualucci A, et al. Laparoscopic vs open splenectomy in the management of hematologic diseases. Surg Endosc. 1999. 13:1220–1225.

15. Rudowski WJ. Accessory spleens: clinical significance with particular reference to the recurrence of idiopathic thrombocytopenic purpura. World J Surg. 1985. 9:422–430.

16. Katkhouda N, Hurwitz MB, Rivera RT, Chandra M, Waldrep DJ, Gugenheim J, et al. Laparoscopic splenectomy: outcome and efficacy in 103 consecutive patients. Ann Surg. 1998. 228:568–578.

17. Akwari OE, Itani KM, Coleman RE, Rosse WF. Splenectomy for primary and recurrent immune thrombocytopenic purpura (ITP): current criteria for patient selection and results. Ann Surg. 1987. 206:529–541.

18. Mintz SJ, Petersen SR, Cheson B, Cordell LJ, Richards RC. Splenectomy for immune thrombocytopenic purpura. Arch Surg. 1981. 116:645–650.