T Shimomatsuya1, T Horiuchi. 1. The Second Department of Surgery, Fukui Medical University, 23 Shimoaizuki, Matsuoka-Cho, Yoshida-Gun, Fukui, 910-1193, Japan.
Abstract
BACKGROUND: Laparoscopic splenectomy (LS) is one of the advanced laparoscopic procedures that benefit most from minimally invasive surgery. This study was undertaken to compare the operating time, blood loss, length of hospital stay, and platelet count response for patients with idiopathic thrombocytopenic purpura (ITP) undergoing open splenectomy (OS) versus LS. METHODS: We performed OS in 20 cases before 1992 and LS in 14 cases after 1993 for the treatment of ITP. RESULTS: The operating time was significantly shorter for OS than for LS (126 +/- 52 min versus 203 +/- 83 min, p < 0.01). Blood loss was less for OS than for LS (321 +/- 264 ml versus 524 +/- 648 ml, p = 0.287). None of the patients who underwent LS were converted to open surgery. Accessory spleens were found in four OS patients (20.0%) and four LS patients (28.6%). The postoperative hospital stay was significantly longer for OS patients than for LS patients (15.2 +/- 5.8 days versus 8.9 +/- 2.9 days, p < 0.0005). No significant difference was noted in the long-term results of splenectomy. CONCLUSIONS: Compared with OS, LS required more operating time, had the potential to cause greater blood loss, had a comparable incidence of accessory spleen and response rate, and appeared to shorten the postoperative stay.
BACKGROUND: Laparoscopic splenectomy (LS) is one of the advanced laparoscopic procedures that benefit most from minimally invasive surgery. This study was undertaken to compare the operating time, blood loss, length of hospital stay, and platelet count response for patients with idiopathic thrombocytopenic purpura (ITP) undergoing open splenectomy (OS) versus LS. METHODS: We performed OS in 20 cases before 1992 and LS in 14 cases after 1993 for the treatment of ITP. RESULTS: The operating time was significantly shorter for OS than for LS (126 +/- 52 min versus 203 +/- 83 min, p < 0.01). Blood loss was less for OS than for LS (321 +/- 264 ml versus 524 +/- 648 ml, p = 0.287). None of the patients who underwent LS were converted to open surgery. Accessory spleens were found in four OSpatients (20.0%) and four LSpatients (28.6%). The postoperative hospital stay was significantly longer for OSpatients than for LSpatients (15.2 +/- 5.8 days versus 8.9 +/- 2.9 days, p < 0.0005). No significant difference was noted in the long-term results of splenectomy. CONCLUSIONS: Compared with OS, LS required more operating time, had the potential to cause greater blood loss, had a comparable incidence of accessory spleen and response rate, and appeared to shorten the postoperative stay.
Authors: R Gelmini; F Romano; N Quaranta; R Caprotti; G Tazzioli; G Colombo; M Saviano; F Uggeri Journal: Surg Endosc Date: 2006-05-11 Impact factor: 4.584
Authors: B Habermalz; S Sauerland; G Decker; B Delaitre; J-F Gigot; E Leandros; K Lechner; M Rhodes; G Silecchia; A Szold; E Targarona; P Torelli; E Neugebauer Journal: Surg Endosc Date: 2008-02-22 Impact factor: 4.584
Authors: F J Berends; N Schep; M A Cuesta; H J Bonjer; M C Kappers-Klunne; P Huijgens; G Kazemier Journal: Surg Endosc Date: 2004-02-02 Impact factor: 4.584
Authors: Abdulmalik M S Altaf; Mark Sawatzky; James Ellsmere; Hendrik Jaap Bonjer; Steven Burrell; Robert Abraham; Stephen Couban; Dennis Klassen Journal: Surg Endosc Date: 2009-01-23 Impact factor: 4.584