Impact of obesity on hand-assisted laparoscopic splenectomy combined with esophagogastric devascu-larization

Abstract

Objective To study the impact of obesity on the perioperative outcomes of hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization (LSED). Methods The clinical data of patients who underwent hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization between Jan. 2013 and Nov. 2015 were retrospectively analyzed. The patients were classified as obese group A (BMI≥28 kg/m2) or non-obese group B (BMI 20 cm) and A2 splenomegaly (diameter ≤20 cm). The conversion rates, operative complications, mortality, length of stay, operative time, and blood loss were analyzed and compared. Results One hundred and sixty patients who underwent hand-assisted LSED were included into this study. 54 patients were in group A and 106 in group B. A significantly longer operative time was found in group A (291 min vs. 261 min, P 0.05). The mean operative time was significantly longer in group A1 (336 min vs. 270 min; P 0.05). Conclusions Hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization for obese patients was safe and feasible. However, for patients with massive splenomegaly, LSED should be performed with caution. Key words: Obesity; Hand-assisted laparoscopic splenectomy; Devascularization; Massive splenomegaly; Perioperative period