Outcome of laparoscopic splenectomy for malignant hematologic diseases.
OBJECTIVE
The role of laparoscopic splenectomy in the treatment of hematological diseases is still controversial. The aim of this study was to assess whether the benign or malignant nature of hematological diseases may influence the outcome of laparoscopic splenectomy.


METHODS
Between August 1997 and March 2002, 63 unselected patients with hematologic diseases underwent a laparoscopic splenectomy. Patients were divided into two groups according to the benign (Group A, 38 patients) or malignant (Group B, 25 patients) nature of the hematological diseases.


RESULTS
Patients in group B were significantly (a) older, (b) had larger spleens that more frequently needed accessory incisions for specimen retrieval, (c) had greater transfusion requirements, and (d) were fed later than patients in group A. There were no statistically significant differences among the two groups in terms of (a) body-mass index, (b) operative time, (c) conversion rate, (d) blood loss, (e) pain medication requirements, and (f) hospital stay. Two postoperative deaths occurred among patients in group B, but none of them was related to surgery.


CONCLUSIONS
The results of the study showed that: a) the nature of the disease does not influence the outcome of laparoscopic splenectomy, b) the size of the spleen might increase the risk of conversion, but it is no longer a contraindication to laparoscopic splenectomy, and c) laparoscopic splenectomy can be effectively performed in the treatment of malignant hematologic diseases.
Cavaliere
Davide
D
Divisione di Chirurgia Generale e Trapianti d'Organo, Genoa, Italy. davidecavaliere@libero.it
Torelli
Paolo
P
Panaro
Fabrizio
F
Casaccia
Marco
M
Ghinolfi
Davide
D
Santori
Gregorio
G
Rossi
Edoardo
E
Bacigalupo
Andrea
A
Valente
Umberto
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006402:Hematologic Diseases / Q000175:diagnosis / Q000601:surgery*; D019337:Hematologic Neoplasms / Q000601:surgery; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome