Laparoscopic splenectomy in children--a multicenter experience.
OBJECTIVE
Splenectomy is frequently required in children for various hematologic pathologic findings. Because of progress in minimally invasive techniques, laparoscopic splenectomy (LS) has become feasible. The objective of this report is to present a multicenter experience of 159 laparoscopic splenectomies.


METHODS
Records of 159 children, who underwent LS in 3 pediatric surgery centers between 1996 and 2006, were reviewed retrospectively with a special questionnaire. The indication for splenectomy were hematologic disorders (147), esophageal varices (6), splenic cyst (5), and tumor of the tail of the pancreas (1). The LS was performed using standard laparoscopic technique and instrumentation.


RESULTS
There were 75 boys and 84 girls. Median age was 12.5 years (range, 2-19.4 years). Laparoscopic splenectomy alone was performed in 118 cases and LS with cholecystectomy or cholecystotomy in 36. In 5 cases, LS was performed together with fundoplication. Eight LS required conversion to an open procedure for following reasons: severe bleeding (3), massive splenomegaly (1), anatomical (2), and technical aspects (2). Accessory spleens were identified in 20 cases (12.6%). There was no mortality. Complications consisted of 8 conversions and postoperatively of mild generalized infection in 3 children and abdominal bleeding that resulted in re-laparoscopy in 1 case.


CONCLUSIONS
Laparoscopic splenectomy can be safely and effectively performed in children.
Murawski
Maciej
M
Department of Surgery and Urology for Children and Adolescents, Medical University of Gdansk, 80-803 Gdansk, Poland.
Patkowski
Dariusz
D
Korlacki
Wojciech
W
Czauderna
Piotr
P
Sroka
Mariusz
M
Makarewicz
Wojciech
W
Czernik
Jerzy
J
Dzielicki
Józef
J
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004932:Esophageal and Gastric Varices / Q000601:surgery; D005260:Female; D006402:Hematologic Diseases / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D010190:Pancreatic Neoplasms / Q000601:surgery; D011044:Poland; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000601:surgery