title: [Can videolaparoscopic access be used as routine in splenectomies?].
abstract: BACKGROUND
  Laparoscopic splenectomy is an alternative for the treatment of patients undergoing elective splenectomy. One of its main indications is in hematologic diseases non-responsive to pharmacological treatment. Videolaparoscopy presents advantages to patients when compared to laparotomy: less post-operative pain, recovery of the functions of the gastrointestinal tract, better cosmetic results and shorter hospitalization.
  
  
  OBJECTIVE
  To present a case series of laparoscopic splenectomy in a university hospital.
  
  
  METHODS
  Were analyzed all the laparoscopic splenectomies between June 2005 and October 2012. The analysis was conducted prospectively divided into pre-, trans-, and post-operative data on: gender, age, indication for surgery, rate of conversion to open surgery, duration of surgery, spleen size, presence of an accessory spleen, time hospitalization and short-term response in eight weeks after the procedure, by analyzing hemoglobin and platelets pre- and post-operative, broken down by gender.
  
  
  RESULTS
  Were analyzed 44 laparoscopic splenectomies performed in the period. Patients diagnosed with idiopathic thrombocytopenic purpura accounted for 56.8%, non-responsive to pharmacological treatment; autoimmune hemolytic anemia was 13.6%; spherocytosis, 11.3% and 18.3% by other non-hemolytic causes. Six patients had to be converted to open surgery (13.63%), four due to excessive bleeding. The mean operative time was 166.7 (60-319) minutes and the length of hospitalization was 12 days. Only four patients (9.1%) had post-operative complications, and none had bleeding after surgery and the positive response in the short term, after eight weeks of treatment, was achieved by 88% of patients.
  
  
  CONCLUSIONS
  Laparoscopic splenectomy is a safe alternative for all major indications of splenectomy and can be routinely used.
authors.affiliation: Serviço de Cirurgia Digestiva do Hospital de Clínicas de Porto Alegre e no Departamento de Cirurgia da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil. eduardontrindade@yahoo.com.br
authors.forename: Eduardo Neubarth
authors.initials: EN
authors.lastname: Trindade
authors.forename: Manoel Roberto Maciel
authors.initials: MR
authors.lastname: Trindade
authors.forename: Ricardo
authors.initials: R
authors.lastname: Francio
authors.forename: Elisa Pedrebon
authors.initials: EP
authors.lastname: Zanella
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013156:Splenectomy / Q000379:methods*; D020535:Video-Assisted Surgery; D055815:Young Adult