Laparoscopic Vs. Open Surgery in Management of Benign Neoplasms of Spleen—Single Institution Experience

Abstract

Laparoscopic splenectomy has become the gold standard for the surgical treatment of most splenic conditions. Benign splenic tumors have been mainly reported as sporadic cases or minimal case series, without significant consideration regarding optimal surgical approach. We conducted a retrospective cohort study from medical records of the 60 patients who had undergone splenectomy due to benign tumors of the spleen from 2003 to 2018. The patients were divided into two groups, first, consisted of 24 patients who underwent laparoscopic splenectomy, and the second group included 36 patients who underwent open splenectomy. We noted slight female predominance (55%) in a group of patients with benign splenic tumors. In the laparoscopic group, intraoperative bleeding amounted to 23.83 ± 15.93 ml, while in the open group, it was 37.06 ± 25.21 ml. The average surgery time in the laparoscopic group was 83.42 ± 17.96 min, while in the open group, it was 93.81 ± 14.62 min. The complication rate was different in favor of the laparoscopic surgery group. Intraoperatively, we detected three accessory spleens which had not been previously noticed during preoperative diagnostics, one in the open group and two in the laparoscopic group. The most common tumor in our study was hemangioma (40%), lymphangioma (35%), and hamartomas (13.3%). Myoid angioendothelioma, SANT, and inflammatory pseudotumor of the spleen were with a prevalence of 6.7%, 3.3%, and 1.7%, successively. Laparoscopic splenectomy should be attempted in all patients with benign splenic tumors when surgical indication exists. It implies a safe treatment with low probability of occurrence of intraoperative and postoperative complications.