101 laparoscopic splenectomies for the treatment of benign and malignant hematologic disorders.
BACKGROUND
Laparoscopic splenectomy (LS) is the surgical approach of choice for patients with hematologic disorders requiring splenectomy. Patients with idiopathic thrombocytopenic purpura (ITP) have normal to slightly enlarged spleens and benefit the most from LS.


METHODS
We reviewed the perioperative outcomes in 101 patients who underwent LS between May 1996 and December 2002. Patients were divided into three groups--ITP, other benign, and malignant hematologic disorders--and compared.


RESULTS
The ITP patients (n = 48) had significantly smaller spleens and operative times compared with the other groups. Splenomegaly in the other benign (n = 23) and malignant hematologic disorders (n = 30) groups was responsible for higher open conversion rates and greater need for hand-assisted laparoscopic splenectomy (HALS).


CONCLUSIONS
Laparoscopic splenectomy and HALS can be performed with good results for benign and malignant hematologic disorders. The benefits of HALS are similar to LS, so there should be a low threshold for HALS in patients with large spleens.
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston VA Medical Center, Houston, TX, USA.
Eric M
EM
Knauer
Gorav
G
Ailawadi
Alan
A
Yahanda
Robert J
RJ
Obermeyer
Michael P
MP
Millie
Herminio
H
Ojeda
Michael W
MW
Mulholland
Lisa
L
Colletti
John F
JF
Sweeney
D016022:Case-Control Studies; D005260:Female; D006402:Hematologic Diseases / Q000601:surgery*; D019337:Hematologic Neoplasms / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery*; D013156:Splenectomy / Q000379:methods; D013163:Splenomegaly / Q000601:surgery