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Background
Laparoscopic splenectomy (LS) has been used to treat a variety of splenic disorders.
However, there have been few direct comparisons of this approach with open splenectomy
(OS).
Methods
Results and outcomes were compared retrospectively in 46 consecutive patients treated
by laparoscopic (n = 26) or open splenectomy (n = 20) from January 1990 through March
1996. The two groups were similar in age, sex, and American Society of Anesthesiology
classification. Splenectomy was performed for a variety of indications, and the majority
of patients in both groups had normal or near-normal size spleens. All data are expressed
as mean ± standard deviation.
Results
Laparoscopic splenectomy was successfully completed in all 26 attempted cases. Operative
times were significantly longer for LS (202 ± 55 minutes) than for OS (134 ± 43 minutes)
(P < 0.001); however, operative times in the last 13 LS cases (176 ± 48 minutes) averaged
51 minutes less than in the first 13 cases (227 ±51 minutes). Estimated operative
blood loss was less for LS (222 ± 280 mL) than for OS (376 ± 500 mL) (P = not significant). A mean of 2.0 units of red blood cells was transfused in 4 (15%)
of 26 patients during LS vs 1.0 unit transfused in 2 (10%) of 20 patients who had
OS (P = NS). Patients who underwent LS required significantly less parenteral pain medications,
had a more rapid return to regular diet, and were discharged sooner than patients
who had OS. Complication rates were similar in the two groups.
Conclusions
These results suggest that LS is technically safe and has several advantages over
OS. Laparoscopic splenectomy should become the procedure of choice for the removal
of normal and near-normal size spleens.
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Article info
Footnotes
*Presented at the 48th Annual Meeting of the Southwestern Surgical Congress, Scottsdale, Arizona, April 28–May 1, 1996.
Identification
Copyright
© 1996 Excerpta Medica, Inc. All rights reserved. Published by Elsevier Inc.
