title: The Italian Registry of Laparoscopic Surgery of the Spleen (IRLSS) A retrospective review of 379 patients undergoing laparoscopic splenectomy.
abstract: In December 2000, the Italian Registry of Laparoscopic Surgery of the Spleen (IRLSS) was formally launched under the auspices of the Italian Society for Endoscopic Surgery and New Technologies (SICE). The aim of this multicentre study was to analyse various aspects of the treatment that are still under discussion, such as the extension of the laparoscopic indications in cases of malignancy, independently of the associated splenomegaly, patient selection and operative techniques. A retrospective review of 379 patients undergoing laparoscopic splenectomy for haematological diseases from February 1, 1993, to September 15, 2005, was conducted. Data were collected from the 18 italian centres participating in the IRLSS. The mean length of surgery was 140 minutes (range: 25-420). Conversion was necessary in 25 cases (6.6%), and at least one accessory spleen was found in 30 patients (8%). The mean spleen weight was 1200 g (range: 85-4500). Perioperative death occurred in two cases (0.5%). There were no complications in 312 patients (82.3%), with a mean hospital stay of 5.5 days (range: 2-30). Morbidity occurred in 67 patients (17.8%), mainly consisting in transient fever (n = 22), pleural effusions (n = 16), and actual or suspected haemorrhage (n = 14), requiring re-intervention in 7 patients. This first study carried out on the IRLSS data shows that laparoscopic splenectomy may constitute the gold standard for haematological diseases with a normal-sized spleen. The low morbidity and mortality rates suggest that laparoscopic splenectomy can be successfully proposed also for splenomegaly in haematological malignancies.
authors.affiliation: Unità di Laparoscopia Avanzata, Dipartimento di Chirurgia Generale e Trapianti, Ospedale San Martino, Università di Genova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Casaccia
authors.forename: Paolo
authors.initials: P
authors.lastname: Torelli
authors.forename: Sandro
authors.initials: S
authors.lastname: Squarcia
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Sormani
authors.forename: Alfredo
authors.initials: A
authors.lastname: Savelli
authors.forename: Bianca Maria
authors.initials: BM
authors.lastname: Troilo
authors.forename: Gregorio
authors.initials: G
authors.lastname: Santori
authors.forename: Umberto
authors.initials: U
authors.lastname: Valente
authors.forename: Nicola
authors.initials: N
authors.lastname: Basso
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Silecchia
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bresadola
authors.forename: Giovanni
authors.initials: G
authors.lastname: Terrosu
authors.forename: Andrea
authors.initials: A
authors.lastname: Pietrabissa
authors.forename: Franco Mosca Andrea
authors.initials: FM
authors.lastname: Valeri
authors.forename: Paolo
authors.initials: P
authors.lastname: Prosperi
authors.forename: Massimo
authors.initials: M
authors.lastname: Saviano
authors.forename: Roberta
authors.initials: R
authors.lastname: Gelmini
authors.forename: Franco
authors.initials: F
authors.lastname: Uggeri
authors.forename: Roberto
authors.initials: R
authors.lastname: Caprotti
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Romano
authors.forename: Gaetano
authors.initials: G
authors.lastname: Logrieco
authors.forename: Aldo
authors.initials: A
authors.lastname: Moraldini
authors.forename: Andrea
authors.initials: A
authors.lastname: Dallatorre
authors.forename: Riccardo
authors.initials: R
authors.lastname: Rosati
authors.forename: Stefano
authors.initials: S
authors.lastname: Bona
authors.forename: Paolo
authors.initials: P
authors.lastname: Cavaliere
authors.forename: Davide
authors.initials: D
authors.lastname: Cavaliere
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Spinoglio
authors.forename: Francesco
authors.initials: F
authors.lastname: Buccoliero
authors.forename: Rossana
authors.initials: R
authors.lastname: Berta
authors.forename: Claudio
authors.initials: C
authors.lastname: Pedrazzolir
authors.forename: Luciano
authors.initials: L
authors.lastname: Bigi
authors.forename: Italo Marco
authors.initials: IM
authors.lastname: Barbieri
authors.forename: Ippolito
authors.initials: I
authors.lastname: Donini
authors.forename: Annibale
authors.initials: A
authors.lastname: Donini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Colecchia
authors.forename: Enzo
authors.initials: E
authors.lastname: Monteferrante
authors.forename: Fernando
authors.initials: F
authors.lastname: Prete
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Memeo
authors.forename: Francesco
authors.initials: F
authors.lastname: Puglisi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006402:Hematologic Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007558:Italy; D010535:Laparoscopy; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods; D013163:Splenomegaly / Q000601:surgery*; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome