Laparoscopic splenectomy in pediatric patients with hematologic diseases.
OBJECTIVE
The aim of this study was to evaluate our experience with laparoscopic splenectomy in pediatric patients with hematologic diseases.


METHODS
A retrospective chart review was performed to analyze the following: indication for splenectomy, pre- and peri-operative management, surgical technique, complications, duration of hospitalization, and outcome.


RESULTS
Eleven patients underwent laparoscopic splenectomy for the following indications: recurrent thrombocytopenia (<10,000) in seven with chronic immune thrombocytopenic purpura; anemia in two with hereditary spherocytosis; and hypersplenism in one and recurrent splenic sequestration in another with homozygous hemoglobin S. The six girls and five boys had a median age of 7 years. The median operative time was 180 minutes, and the median hospitalization was 72 hours. Among the patients with immune thrombocytopenic purpura (median platelet count, 153,000), those patients (n=3) with platelet counts of <100,000 did not suffer any bleeding complications. The patient with hypersplenism and homozygous hemoglobin S required a small incision in the left lower quadrant to facilitate removal of a 558-gram spleen. This patient also underwent cholecystectomy for cholelithiasis. The operative time was 295 minutes, and he was hospitalized for 5 days because of atelectasis.


CONCLUSIONS
Laparoscopic splenectomy is a safe and effective procedure in children with hematological disorders.
Department of Pediatrics, New York Medical College, Westchester Medical Center, Valhalla, USA.
C
C
Sandoval
G
G
Stringel
M F
MF
Ozkaynak
O
O
Tugal
S
S
Jayabose
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006402:Hematologic Diseases / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D012189:Retrospective Studies; D012449:Safety; D013156:Splenectomy / Q000379:methods*