Laparoscopic splenectomy in patients with hematologic malignancies.
BACKGROUND
Although laparoscopic splenectomy (LS) for benign hematologic disease is well accepted, its role in hematologic malignancies is not clearly defined. This study examined the efficacy and feasibility of LS for hematologic malignancies.


METHODS
Records were reviewed from patients who underwent LS at two university hospitals. Charts from 77 open splenectomies for malignancy (OM) during the same period were also reviewed.


RESULTS
Fifty-three patients underwent LS, 22 for hematologic malignancies (LM) and 31 for benign hematologic disorders (LB). Median splenic weight was greater in the LM group (930 g) than in the LB group (164 g, P = 0.001). LM was associated with longer operations and greater blood loss than was LB. LM had a 41% conversion rate. Morbidity, mortality, and transfusion rates were similar. Median hospital stay was shorter for LM (4 days) than for OM (6 days, P = 0.001).


CONCLUSIONS
LS is feasible in hematologic malignancies but is associated with increased operative time and blood loss and a high conversion rate. Morbidity and mortality, however, was similar. Shorter hospital stays for LM compared with OM may translate into earlier recovery and initiation of antineoplastic therapy.
Berman
R S
RS
Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Yahanda
A M
AM
Mansfield
P F
PF
Hemmila
M R
MR
Sweeney
J F
JF
Porter
G A
GA
Kumparatana
M
M
Leroux
B
B
Pollock
R E
RE
Feig
B W
BW
D000328:Adult; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D005260:Female; D006402:Hematologic Diseases / Q000601:surgery; D019337:Hematologic Neoplasms / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012449:Safety; D013156:Splenectomy / Q000379:methods* / Q000706:statistics & numerical data; D013997:Time Factors