Laparoscopic versus open splenectomy for splenomegaly: the verdict is unclear.

Surgical Endoscopy
Reuben D ShinAli Tavakkoli

Abstract

The benefits of laparoscopic splenectomy (LS) over open splenectomy (OS) for normal-sized spleens have been well documented. However, the role of laparoscopy for moderate and massive splenomegaly is debated. A retrospective review of patients undergoing elective splenectomy at one institution from 1997 to 2017 was conducted. Moderate and massive splenomegaly was defined as splenic weight of 500-1000 g and greater than 1000 g, respectively. We performed a 1:2 matching of laparoscopic to open splenectomy to control for differences in splenic weight. Differences in perioperative morbidity (infection, thromboembolism, reoperation, readmission), intraoperative factors (blood loss, operative time), length of stay, and mortality were examined. A total of 491 elective splenectomies were identified. 268 cases were for splenic weights greater than 500 g. After a 1:2 matching of LS:OS, we identified 22 LS and 44 matched OS for moderate splenomegaly. The LS group had longer mean operative times (178 vs. 107 min, p < 0.01), with similar length of stay and blood loss. For massive splenomegaly, 26 LS were identified and matched to 52 OS. LS had longer mean operative times (171 vs. 112 min, p < 0.01) and higher readmission rates (27% vs. 6%, p...Continue Reading

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Citations

May 29, 2019·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Vecchio Rosario, Intagliata Eva
Aug 3, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·S G PopeskouC Toso
Jul 31, 2019·Surgical Endoscopy·Peter SzaszAli Tavakkoli
Dec 2, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Michael D TraynorMichael B Ishitani
Nov 13, 2020·World Journal of Surgery·María Rita Rodríguez-LunaEduardo María Targarona Soler
Jul 1, 2021·Annals of Medicine and Surgery·Mohammad Gharieb KhirallahNagi Ebrahim El-Dessouki

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