title: [Laparoscopic splenectomy in hematologic diseases in children. Analysis of 11-year experience].
abstract: OBJECTIVE
  A common indication for splenectomy in children is hematologic diseases. Indications, clinical course and complications of laparoscopic splenectomy are shown; factors associated with open conversion are analyzed.
  
  
  METHODS
  Retrospective, longitudinal, descriptive series of laparoscopic splenectomy during 11 years and its long-term follow-up.
  
  
  RESULTS
  We studied 88 laparoscopic splenectomies. Average age was 9 years and weight 30 kg. The indication was hemolytic anemia in 77% and thrombocytopenic purpura in 18%. Eleven percent was operated with severe thrombocytopenia and two patients urgently; cholecystectomy was done in 13%. The median surgical time was 180 minutes and bleeding 100 ml. Conversion rate was 5.7% mainly because of persistent bleeding, being risk bleeding greater than 300 ml and the need for red cell concentrate transfusion. The median length of stay was 3 days, longer in those affected by purpura. Three patients developed pneumonia and one, intra-abdominal abscess. Follow-up was 3.6 years average with two late complications. Treatment response was cure in 72%, improvement in 11.3% and failure in 6.8%.
  
  
  CONCLUSIONS
  It is feasible to operate patients under 5 years of age and patients with anemia or thrombocytopenia at the time of surgery without major problems. The conversion rate is low and risk factors for conversion are bleeding more than 300 ml and needing to transfuse erythrocyte concentrate.
authors: Departamento de Cirugía General. Hospital Infantil de México Federico Gómez, Secretaría de Salud, México, D.F.
authors: E
authors: E
authors: Bracho-Blanchet
authors: Departamento de Cirugía General. Hospital Infantil de México Federico Gómez, Secretaría de Salud, México, D.F.
authors: R
authors: R
authors: Dávila-Pérez
authors: Departamento de Cirugía General. Hospital Infantil de México Federico Gómez, Secretaría de Salud, México, D.F.
authors: C
authors: C
authors: Zalles-Vidal
authors: Departamento de Cirugía General. Hospital Infantil de México Federico Gómez, Secretaría de Salud, México, D.F.
authors: E
authors: E
authors: Fernández-Portilla
authors: Departamento de Cirugía General. Hospital Infantil de México Federico Gómez, Secretaría de Salud, México, D.F.
authors: R
authors: R
authors: Ordorica-Chávez
authors: Departamento de Cirugía General. Hospital Infantil de México Federico Gómez, Secretaría de Salud, México, D.F.
authors: J
authors: J
authors: Nieto-Zermeño
keywords: Children; Hematologic diseases; Laparoscopy; Splenectomy