title: Splenic artery embolization before laparoscopic splenectomy in children.
abstract: BACKGROUND
  This study assessed the safety and utility of preoperative splenic artery embolization before laparoscopic splenectomy in children.
  
  
  METHODS
  Five young girls with a mean age of 13.2 years underwent laparoscopic splenectomies at the authors' institution from August 1998 to April 2003. Three of the patients had idiopathic thrombocytopenic purpura, and two had hereditary spherocytosis. Preoperative splenic artery embolization was performed the day before the surgery in all cases. The laparoscopic splenectomy was performed using traditional laparoscopic procedures and standard laparoscopic instruments with the patient in the right semilateral position.
  
  
  RESULTS
  The mean spleen weight was 252.6 g, and the mean length was 11.6 cm. All the patients reported postembolic pain, but not to a level unmanageable by intravascular narcotics. There were no severe complications in the splenic artery embolization. The laparoscopic splenectomies were completed in a mean of 211 min, with a mean estimated blood loss of 9 ml. None of the operations required conversion to traditional open laparotomy, and none of the patients died or experienced operative complications.
  
  
  CONCLUSIONS
  The authors concluded that splenic artery embolization is safe and useful as an adjuvant procedure performed before elective laparoscopic splenectomy in children.
authors.affiliation: First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Tokyo, 113-8605, Japan. tsubasa1215@nms.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: Y
authors.initials: Y
authors.lastname: Arima
authors.forename: S
authors.initials: S
authors.lastname: Yokomuro
authors.forename: H
authors.initials: H
authors.lastname: Yoshida
authors.forename: Y
authors.initials: Y
authors.lastname: Mamada
authors.forename: N
authors.initials: N
authors.lastname: Taniai
authors.forename: Y
authors.initials: Y
authors.lastname: Kawano
authors.forename: Y
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: T
authors.initials: T
authors.lastname: Shimizu
authors.forename: K
authors.initials: K
authors.lastname: Akimaru
authors.forename: T
authors.initials: T
authors.lastname: Tajiri
mesh_terms: D000293:Adolescent; D002648:Child; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D010535:Laparoscopy; D011300:Preoperative Care; D013156:Splenectomy / Q000379:methods*; D013157:Splenic Artery