[Laparoscopic splenectomy in pediatric hematologic diseases].
BACKGROUND
Surgical acceptance of the laparoscopic splenectomy in the pediatric hematological disorders has improved due to safety, to relif postoperative pain, and to reduce the hospital stay. The aim of this study is present our surgical laparoscopic technique performed.


METHODS
Eight patients, 6 spherocytosis (age ranged: 6-14 years, average age: 9.5 years; 5 girls and 1 boy) and 2 cases of autoimmune hemolytic anemia (both boys of 18 months and 4 years) underwent laparoscopic splenectomy. The Trias-Targarona technique has been performed placing the patient at the right lateral-decubitus position. Four trocars are placed, two of 5 mm in the posterior axillary line and epigastrium and other 2 trocars of 12 mm, in the middle of them.


RESULTS
In all these 8 patients a laparoscopic splenectomy was completely performed. We had 2 cases with problems with the sac introduction. Cosmetic results have been excellent and we changed the 7-day antibiotic protocol for 2-day protocol. The surgical time has changed from 3 to 2 hours.


CONCLUSIONS
With laparoscopic splenectomy we can give an adequate response to hematological disorders in children with a acceptable surgical time, an excellent cosmetic result with a minimum postoperative time and a very short hospital stay.
Martínez Ibáñez
V
V
Departamento Cirugía Pediátrica, Hospital Materno-Infantil Vall d'Hebron, Barcelona.
Lloret
J
J
Targarona
E
E
Tusell
J
J
Abad
P
P
al-Kassab
H
H
Trías
M
M
Boix-Ochoa
J
J
D000293:Adolescent; D002648:Child; D005260:Female; D006402:Hematologic Diseases / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D013156:Splenectomy / Q000379:methods*