Laparoscopic partial splenectomy.
BACKGROUND
The immunologic function of the spleen and its important role in immune defense has led to splenic-preserving surgery. This study aimed to evaluate whether laparoscopic partial splenectomy is safe.


METHODS
Data on consecutive patients presenting with localized benign or malignant disease of the spleen were included in a prospective database. The surgical technique consisted of six steps: patient positioning and trocar placement, mobilization of the spleen, vascular dissection, parenchymal resection, sealing/tamponading of the transected edge, and removal of the specimen.


RESULTS
From 1994 to 2005, 38 patients underwent laparoscopic partial splenectomy. The indications included splenomegaly of unknown origin, splenic cysts, benign tumors (hamartoma), and metastasis from ovarian carcinoma and schwannoma. The median operating time was 110 min (range, 65-148 min). The median length of hospital stay was 5 days (range, 4-7 days). There was no postoperative mortality. Postoperative pleural effusion occurred in two patients. There were no reoperations. Three patients required blood transfusions.


CONCLUSIONS
Laparoscopic partial splenectomy is safe for patients with localized benign or malignant disease of the spleen.
Uranues
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S
Department of Surgery, Lehigh Valley Hospital, Penn State University Clinical Campus, 1240 South Cedar Crest Boulevard, Suite 210, Allentown, PA 18103, USA. Sally.lutz@lvh.com
Grossman
D
D
Ludwig
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L
Bergamaschi
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000556:secondary / Q000601:surgery; D003560:Cysts / Q000601:surgery; D016208:Databases, Factual; D005260:Female; D006222:Hamartoma / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000556:secondary / Q000601:surgery; D010051:Ovarian Neoplasms / Q000556:secondary / Q000601:surgery; D010996:Pleural Effusion / Q000209:etiology; D013156:Splenectomy / Q000009:adverse effects* / Q000379:methods*; D013158:Splenic Diseases / Q000601:surgery*; D013160:Splenic Neoplasms / Q000601:surgery; D013163:Splenomegaly / Q000601:surgery; D013997:Time Factors