Laparoscopic splenectomy: outcomes and lessons learned from over 200 cases.
BACKGROUND
In this study of laparoscopic splenectomy (LS), we evaluate prospectively gathered perioperative patient data and review lessons learned in the evolution of this procedure.


METHODS
At 2 university medical centers between November 1993 and March 2000, there were 203 patients (122 female patients and 81 male patients) who underwent LS after preoperative evaluation.


RESULTS
LS was successfully completed in 197 patients (97%). The mean operative time was 145.5 minutes and the length of stay averaged 2.7 days with 143 (70.4%) staying less than 48 hours. The most common indication was idiopathic thrombocytopenic purpura (ITP). Six patients required conversion to open splenectomy (OS), with only 2 conversions in the last 163 cases. No deaths were attributed to the procedure. Complications occurred in 19 patients (9.3%). Thirty accessory spleens were identified in 25 patients (12.3%). Seventeen patients (8.4%) underwent concomitant procedures, most commonly cholecystectomy.


CONCLUSIONS
LS by the lateral approach is both safe and feasible in patients of all ages.
Park
A E
AE
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington, KY, USA.
Birgisson
G
G
Mastrangelo
M J
MJ
Marcaccio
M J
MJ
Witzke
D B
DB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery*; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000601:surgery; D016896:Treatment Outcome