Spleen surgery in pediatric age: seven-year unicentric experience.
BACKGROUND
Either "open" and laparoscopic spleen surgery in pediatric age are well known and performed with ease in children. Yet, few data regarding follow-up and outcome are discussed in the international literature.


METHODS
Clinical notes of all patient who underwent spleen surgery in a single center between 2000 and 2007 were reviewed and a specific follow-up questionnaire was administered, aiming to evaluate pre- and postoperative data, especially considering underlying disease, cosmetic results, and quality of life after surgery.


RESULTS
Fifty-one patients underwent spleen surgery in our series, 33 of whom returned a complete follow-up questionnaire and were included in the study. Splenectomy was performed in 26 patients, whereas 7 patients underwent a partial splenectomy; 19 cases (57.6%) were approached laparoscopically. A total of 4 complications (12%) occurred in our series, none of them being intraoperative. Hospital stay resulted as significantly shorter in laparoscopic cases (5.5 +/- 2.9 vs. 8.7 +/- 4.8 days; P < 0.01), with better results in terms of cosmetics. Quality of life is strictly related to underlying disease, as well as long-term survival.


CONCLUSIONS
Whatever surgical approach is adopted, spleen surgery is safe, effective, and reproducible. When feasible, the laparoscopic approach should be preferred to the traditional open approach, as far as efficacy and safety are similar, in order to reduce hospital stay, abdominal wall traumatism, and consequently, improve postoperative pain control and cosmetic results.
Mattioli
Girolamo
G
Department of Pediatric Surgery, G. Gaslini Children's University Institute, Genoa, Italy., University of Genoa, Genoa, Italy. girolamomattioli@ospedale-gaslini.ge.it
Avanzini
Stefano
S
Pini Prato
Alessio
A
Asquasciati
Caterina
C
Rapuzzi
Giovanni
G
Costanzo
Sara
S
Basile
Angela
A
Rossi
Valentina
V
Bisio
Giovanni
G
Boeri
Elio
E
Montobbio
Giovanni
G
Jasonni
Vincenzo
V
D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011788:Quality of Life; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000601:surgery*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome