BACKGROUND: Massive and supramassive splenomegaly are relative contraindications to pure laparoscopic splenectomy (LS). METHODS: A retrospective review of adult patients was conducted for splenectomy occurring from 1999 to 2009. Massive and supramassive spleens were defined as craniocaudad length ≥ 17 cm or weight ≥ 600 g and craniocaudad length ≥ 22 cm or weight ≥ 1,600 g, respectively. RESULTS: LS was done for 22 and open splenectomy for 21 patients, of which 12 and 14 were supramassive. Spleen weight and craniocaudad length were comparable. LS was associated with lower blood loss (308 vs 400 mL, P = .24), shorter length of stay (3 vs 4.5 days, P = .054), and similar morbidity (17% vs 14%). Two reoperations and 1 death occurred with open splenectomy. Operative times were longer for LS (195 vs 105 min, P = .008), while the conversion rate was 25%. CONCLUSIONS: In cases of massive and supramassive splenomegaly, better outcomes are accomplished with LS than open splenectomy, and are comparable to hand-assisted LS.
BACKGROUND: Massive and supramassive splenomegaly are relative contraindications to pure laparoscopic splenectomy (LS). METHODS: A retrospective review of adult patients was conducted for splenectomy occurring from 1999 to 2009. Massive and supramassive spleens were defined as craniocaudad length ≥ 17 cm or weight ≥ 600 g and craniocaudad length ≥ 22 cm or weight ≥ 1,600 g, respectively. RESULTS:LS was done for 22 and open splenectomy for 21 patients, of which 12 and 14 were supramassive. Spleen weight and craniocaudad length were comparable. LS was associated with lower blood loss (308 vs 400 mL, P = .24), shorter length of stay (3 vs 4.5 days, P = .054), and similar morbidity (17% vs 14%). Two reoperations and 1 death occurred with open splenectomy. Operative times were longer for LS (195 vs 105 min, P = .008), while the conversion rate was 25%. CONCLUSIONS: In cases of massive and supramassive splenomegaly, better outcomes are accomplished with LS than open splenectomy, and are comparable to hand-assisted LS.
Authors: María Rita Rodríguez-Luna; Carmen Balagué; Sonia Fernández-Ananín; Ramon Vilallonga; Eduardo María Targarona Soler Journal: World J Surg Date: 2020-11-11 Impact factor: 3.352
Authors: Reuben D Shin; Roger Lis; Nicholas R Levergood; David C Brooks; Brent T Shoji; Ali Tavakkoli Journal: Surg Endosc Date: 2018-08-27 Impact factor: 4.584
Authors: Robert Naples; Alexander Bertke; Aldo Fafaj; Samuel J Zolin; Jonah D Thomas; Clayton Petro; David Krpata; Ajita S Prabhu; Michael J Rosen; Steven Rosenblatt Journal: World J Surg Date: 2020-09 Impact factor: 3.352