Comparison of laparoscopic versus open splenectomy for hematologic diseases

Abstract

Objective To compare laparoscopic splenectomy (LS) versus open splenectomy (OS) for the treatment of hematologic diseases in children.Methods Retrospective reviews were conducted for the clinical records of 73 children undergoing splenectomy for hematologic diseases at our institution during January 2003 to November 2013.According to different operative approaches,LS (n =35) and OS (n =38) were assigned and compared.The follow-up period was 1 month to 10 years.Results Both groups underwent splenectomy.A total of 33 total LS were performed successfully.Conversion was performed with small incision in 2 patients.The average operative duration was (126 ± 38) min for LS versus (100 ± 45) min for OS (P＜0.05) ; average intraoperative blood loss (36.7 ± 20.6) ml for LS versus (33.2 ± 16.8) ml for OS (P＞0.05).Time to resumption of oral intake averaged 1.5 days for LS and 2.5 days for OS (P＜0.05).The incidence of accessory spleens was 42.8％ for LS and 31.5％ for OS.The postoperative complications were 8.6％ for LS and 13.2％ for OS respectively.The long-term efficacies of LS and OS were similar in the management of hematologic diseases.Conclusions LS is feasible,efficacious and safe for hematological diseases in children.It offers many advantages of mini-invasiveness,quick recovery,fewer postoperative complications and a higher discovery rate of accessory spleens over OS. Key words: Laparoscopy;  Splenectomy;  Hematologic disease