Laparoscopic splenectomy for treatment of splenomegaly.
BACKGROUND
Laparoscopic splenectomy presents an advantage over open splenectomy, resulting in shorter hospital stay, decreased blood loss, and fewer operative and postoperative complications. Splenomegaly has long been considered a contraindication for laparoscopic splenectomy; however, in the hands of an experienced surgeon, this technique can be effectively applied to the treatment of splenomegaly.


METHODS
Records for patients undergoing laparoscopic splenectomy for splenomegaly between 2000 and 2003, performed by a single surgeon in three community-based hospitals, were reviewed and demographic, operative, and postoperative data compiled. Preoperative diagnoses included B cell lymphoma, hemolytic anemia, and chronic lymphocytic leukemia.


RESULTS
Seven patients underwent laparoscopic and hand-assisted laparoscopic splenectomy for splenomegaly during this time period. Splenic weights ranged from 410 to 3,100 g, and average operative time was 86.6 minutes. Estimated blood loss ranged from 50 to 350 ml; average hospital stay was 4.4 days. Two postoperative complications, ie, postoperative bleeding and superficial wound breakdown, were noted.


CONCLUSIONS
Laparoscopic and hand-assisted laparoscopic splenectomy are effective methods for treatment of splenomegaly.
Smith
Leah
L
Associated Surgeons, P.S., 104 West 5th Ave., Suite 350E, Spokane, WA 99204, USA.
Luna
Gregory
G
Merg
Anders R
AR
McNevin
M Shane
MS
Moore
Michael R
MR
Bax
Timothy W
TW
D000368:Aged; D000743:Anemia, Hemolytic / Q000150:complications; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D000075202:Contraindications; D006764:Hospitals, Community; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications; D016393:Lymphoma, B-Cell / Q000150:complications; D009929:Organ Size; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*; D013163:Splenomegaly / Q000209:etiology / Q000601:surgery*; D013396:Suction; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome