Laparoscopic versus open splenectomy in the management of splenomegaly: our preliminary experience.
BACKGROUND
Laparoscopic splenectomy for normal-sized spleens has several advantages compared with laparotomy. Only a few cases of splenomegaly done by laparoscopy are reported in the literature. The purpose of this study is to show that laparoscopy for splenomegaly is feasible and has several advantages over the open operation.


METHODS
We performed retrospective chart review of 8 cases of splenomegaly managed by laparoscopy (group 1), 15 cases of open splenomegaly (group 2), and 27 cases of laparoscopic splenectomy for normal-sized spleens (group 3). Comparison has been done between groups 1 and 2 and groups 1 and 3 in terms of operative time, intraoperative estimated blood loss, need for blood transfusion, postoperative ileus, postoperative stay, and mortality and morbidity rates.


RESULTS
Patients in group 1 required longer operative time and significantly less intraoperative blood transfusion compared with group 2. The postoperative course was less complicated and shorter in group 1 than in group 2. Operative time was longer in group 1 compared with group 3. No significant differences in terms of postoperative course have been found between groups 1 and 3.


CONCLUSIONS
Laparoscopy for splenomegaly is a feasible, effective, and safe technique for experienced laparoscopic surgeons. This approach seems to have several advantages over the open operation. Prospective, randomized trials would be required for a proper quantitative evaluation.
Terrosu
G
G
Department of Surgery, University Hospital Udine, Italy.
Donini
A
A
Baccarani
U
U
Vianello
V
V
Anania
G
G
Zala
F
F
Pasqualucci
A
A
Bresadola
F
F
Pasgualucci
A
A
D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy; D013163:Splenomegaly / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome