PURPOSE: Laparoscopy is an increasingly prevalent choice for elective splenectomy but it carries an inconsistent documentation of complications. This study examines 30-day postoperative outcomes after open (OS) and laparoscopic (LS) splenectomy. METHODS: Elective splenectomies were extracted from the National Surgical Quality Improvement Program database. Multivariate analysis determined factors associated with complications and an increased postoperative length of stay (LOS). RESULTS: There were a total of 1583 splenectomies with 991 (63.0%) laparoscopic cases. On univariate analysis, the LS group had fewer major (10.6% vs. 18.8%, P<0.0001) and minor complications (2.6% vs. 7.1%, P<0.0001). Adjusting for baseline differences, LS was not associated with an increase in major complications [odds ratio (OR), 0.76; 95% confidence interval, 0.54-1.08; P = 0.1255] but offered a decrease in minor complications (OR, 0.41; 95% confidence interval, 0.24-0.69; P = 0.0010) coupled with a decrease in postoperative LOS of 1.89 ± 0.30 days (P<0.0001) compared with OS. CONCLUSIONS: After accounting for comorbidities and intraoperative factors, laparoscopy remains a safe choice for elective splenectomy with fewer complications and shorter LOS.
PURPOSE: Laparoscopy is an increasingly prevalent choice for elective splenectomy but it carries an inconsistent documentation of complications. This study examines 30-day postoperative outcomes after open (OS) and laparoscopic (LS) splenectomy. METHODS: Elective splenectomies were extracted from the National Surgical Quality Improvement Program database. Multivariate analysis determined factors associated with complications and an increased postoperative length of stay (LOS). RESULTS: There were a total of 1583 splenectomies with 991 (63.0%) laparoscopic cases. On univariate analysis, the LS group had fewer major (10.6% vs. 18.8%, P<0.0001) and minor complications (2.6% vs. 7.1%, P<0.0001). Adjusting for baseline differences, LS was not associated with an increase in major complications [odds ratio (OR), 0.76; 95% confidence interval, 0.54-1.08; P = 0.1255] but offered a decrease in minor complications (OR, 0.41; 95% confidence interval, 0.24-0.69; P = 0.0010) coupled with a decrease in postoperative LOS of 1.89 ± 0.30 days (P<0.0001) compared with OS. CONCLUSIONS: After accounting for comorbidities and intraoperative factors, laparoscopy remains a safe choice for elective splenectomy with fewer complications and shorter LOS.
Authors: Dorota Radkowiak; Anna Zychowicz; Michał Wysocki; Anna Lasek; Piotr Major; Michał Pędziwiatr; Piotr Budzyński; Marcin Dembiński; Jadwiga Dworak; Andrzej Budzynski Journal: Wideochir Inne Tech Maloinwazyjne Date: 2018-05-30 Impact factor: 1.195