title: Perioperative outcomes of laparoscopic versus open splenectomy for nontraumatic diseases: a meta-analysis.
abstract: BACKGROUND
  Surgical treatment has become the standard treatment for nontraumatic diseases of the spleen. This meta-analysis compared the relative merits of laparoscopic splenectomy (LS) with open splenectomy (OS) for nontraumatic splenic diseases.
  
  
  METHODS
  A literature search was performed to identify studies comparing perioperative outcomes in patients who underwent LS or OS for nontraumatic diseases. Pooled odds ratios (ORs) and weighted mean differences (WMD) with 95% confidence intervals (CIs) were calculated using a fixed- or random-effects model.
  
  
  RESULTS
  Thirty-five studies matched the selection criteria. Of the 7 269 patients included 3 981 underwent LS and 3 288 underwent OS for nontraumatic diseases. OS was associated with shorter operation time (WMD = 42.65, 95% CI: 25.58-59.73), whereas LS was associated with reduced operative blood loss (WMD = -133.95, 95% CI: -229.02 to -38.88), need for blood transfusion requirement (OR = 0.53, 95% CI: 0.39-0.72), overall postoperative morbidity rate (OR = 0.44, 95% CI: 0.38-0.51), postoperative mortality rate (OR = 0.38, 95% CI: 0.24-0.59), and length of hospital stay (WMD = -2.73, 95% CI: -3.34 to -2.12).
  
  
  CONCLUSIONS
  LS is superior to OS for nontraumatic diseases, with reduced operative blood loss, need for blood transfusion, postoperative morbidity and mortality rates, and length of hospital stay, although OS is associated with reduced operation time. LS may be a good alternative to OS for patients with nontraumatic splenic diseases.
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Institute of Minimally Invasive Surgery of Zhejiang University, Hangzhou, Zhejiang 310016, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Surgery, Zhejiang University Hospital, Zhejiang University, Hangzhou, Zhejiang 310027, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Ma
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Institute of Minimally Invasive Surgery of Zhejiang University, Hangzhou, Zhejiang 310016, China.
authors.forename: Shouzhang
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Institute of Minimally Invasive Surgery of Zhejiang University, Hangzhou, Zhejiang 310016, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Lin
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Institute of Minimally Invasive Surgery of Zhejiang University, Hangzhou, Zhejiang 310016, China.
authors.forename: Shilin
authors.initials: S
authors.lastname: He
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Institute of Minimally Invasive Surgery of Zhejiang University, Hangzhou, Zhejiang 310016, China. Email: cxjzu@hotmail.com.
authors.forename: Xiujun
authors.initials: X
authors.lastname: Cai
mesh_terms: D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D013154:Spleen / Q000601:surgery; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*; D013158:Splenic Diseases / Q000601:surgery*