Laparoscopic splenectomy in children.
BACKGROUND
Laparoscopic splenectomy is being performed more commonly in children, although its advantages are not clear. We sought to determine whether laparoscopic splenectomy was superior to open splenectomy.


METHODS
The records of all pediatric patients undergoing splenectomy without significant comorbidities over a 12-year period were examined. The patients were divided into those undergoing laparoscopic splenectomy and those undergoing open splenectomy. Demographics, operative time, estimated blood loss, spleen size, length of stay, and total charges were compared between the groups.


RESULTS
Eighty-one (58%) children underwent laparoscopic splenectomy, and 59 (42%) children underwent open splenectomy. The groups were similar in age and sex; hereditary spherocytosis was more common in the LS group. Operating time was longer in the laparoscopic splenectomy group (231 +/- 10 min vs 138 +/- 9 min; P<0.001), but blood loss and complication rates were similar. Twelve (15%) conversions were necessary primarily due to spleen size. Although children undergoing LS had a shorter length of stay (2.4 +/- 0.1 vs 4.1 +/- 0.3 days; P<0.001), they incurred higher charges (dollars 21199 +/- 664 vs dollars 15723 +/- 1737; P<0.002).


CONCLUSIONS
Laparoscopic splenectomy is a safe procedure in children, resulting in shorter hospital stay, which may translate into earlier return to activity and a smaller burden on the child's caretakers.
Qureshi
Faisal G
FG
Division of Pediatric Surgery, Children's Hospital of Pittsburgh, University of Pittsburgh, Pennsylvania 15213, USA.
Ergun
Orkan
O
Sandulache
Vlad C
VC
Nadler
Evan P
EP
Ford
Henri R
HR
Hackam
David J
DJ
Kane
Timothy D
TD
D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery; D012189:Retrospective Studies; D013103:Spherocytosis, Hereditary / Q000601:surgery; D013156:Splenectomy / Q000379:methods*