title: Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis.
abstract: OBJECTIVE
  We conducted a systematic review and meta-analysis to compare the clinical outcomes between laparoscopic splenectomy and the traditional open splenectomy in children.
  
  
  METHODS
  Literature searches were conducted to identify studies having compared the laparoscopic splenectomy (LS) and open splenectomy (OS) for children. Parameters such as operative time, blood loss, length of postoperative stay, the removal of accessory spleens and postoperative complications including postoperative high fever, acute chest syndrome (ACS), and ileus were pooled and compared by meta-analysis.
  
  
  RESULTS
  Among the 922 pediatric participants included in the 10 studies, 508 had received LS and 414 OS. There were shorter length of hospital stays, less blood loss, and longer operative times with the LS approach compared with OS. However, no significant difference was found between LS and OS in the secondary outcome, such as the removal of accessory spleens or postoperative complications including postoperative high fever, ACS, and ileus.
  
  
  CONCLUSIONS
  LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. Compared with OS, LS has the advantage of shorter hospital stay and less blood loss. Besides, total postoperative complications may be slightly lower in LS. We conclude that LS should be considered an acceptable option for children.
authors.affiliation: Department of Pediatric Surgery, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, 310015, China.
authors.forename: Shaoguang
authors.initials: S
authors.lastname: Feng
authors.affiliation: Department of Pediatric Surgery, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, 310015, China.
authors.forename: Yuhui
authors.initials: Y
authors.lastname: Qiu
authors.affiliation: Department of Pediatric Surgery, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, 310015, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Pediatric Surgery, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, 310015, China.
authors.forename: Huajun
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Pediatric Surgery, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, 310015, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Pediatric Surgery, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, 310015, China.
authors.forename: Junjia
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Pediatric Surgery, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, 310015, China.
authors.forename: Weiguang
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Pediatric Surgery, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, 310015, China.
authors.forename: Aihe
authors.initials: A
authors.lastname: Wang
authors.affiliation: Department of Pediatric Surgery, Hangzhou Children's Hospital, No. 195 Wenhui Rd, Xiacheng District, Hangzhou, 310015, China. jackiefung@163.com.
authors.forename: Xianming
authors.initials: X
authors.lastname: Yao
authors.affiliation: Institute of Translational Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Xin-He
authors.initials: XH
authors.lastname: Lai
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002648:Child; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D061646:Operative Time; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D013154:Spleen / Q000601:surgery; D013156:Splenectomy / Q000706:statistics & numerical data*
keywords: Children; Laparoscopic; Meta-analysis; Open splenectomy