The effect of laparoscopic partial splenectomy for spleen benign lesions

Abstract

Introduction: To confirm the value of laparoscopic partial splenectomy (LPS) in the surgical therapy of spleen benign lesions. Methods: A total of 22 patents with splenic benign lesions undergone laparoscopic splenectomy in Zhejiang University Huzhou Hospital from Sep 1 2016 to Aug 31 2017 were analyzed retrospectily. Results: Depending on the result of the preoperative imaging evaluation of the lesion's location and the future splenic volume, 7 patients were undergone laparoscopic total splenectomy (LTS) and 15 patients undergone LPS successfully without conversion to open splenectomy or LTS respectively . There is no statistic difference in operating time, intra-operative blood loss and transfusion between the two groups. However, the morbidity of LPS group was significant lower (p = 0.0012), and no thrombocytosis occurred in LPS patients. Additionally, the patients received LPS recovered quickly and the postoperative hospital stay was significant shorter (5.7 ± 2.3 vs. 15.3 ± 3.4 days, p = 0.0001) with a lower medical expenditure (19288 ± 2760 vs. 27737 ± 4626 ¥, p = 0.0013). No thrombocytosis and recurrence were observed during follow up in all 22 patients. Conclusions: According with the idea of enhanced recovery after surgery (ERAS) , LPS is safe and effective surgical therapy to preserve the function of spleen for selected patient with spleen benign lesions. Keywords: Laparoscope, partial splenectomy, spleen benign lesion, spleen preservation, postoperative outcome