title: Lateral Versus Anterior Approach Laparoscopic Splenectomy: A Randomized-controlled Study.
abstract: OBJECTIVE
  The study compares prospectively the hospital stay and postoperative complications of anterior (ALS) versus lateral (LLS) approach for laparoscopic splenectomy.
  
  
  METHODS
  Between September 2011 and April 2015, 94 patients with splenomegaly were referred to the surgical unit in the Oncology Center of Mansoura University, Egypt. Only 80 patients with splenomegaly <30 cm underwent an open-label randomized allocation into 2 equal parallel groups. Indications were hematological in 52 patients (65%) and malignant splenic conditions in 28 patients (35%). Two patients younger than 18 years, 4 patients with splenomegaly >30 cm, and 8 patients with associated surgical comorbidities were excluded. Three days' hospital stay reduction with LLS was suggested with a power of 80% and P-value of 0.05.
  
  
  RESULTS
  The mean hospital stay was significantly shorter (P=0.001) after LLS. Laparoscopic splenectomy was completed in 68 patients (85%). Twelve patients (15%) required open splenectomy with no difference between groups. The operation time was significantly shorter in LLS (P=0.013). Blood loss (P=0.057) and blood transfusion (P=0.376) showed no difference between the two groups. The times until resumption of oral intake (P=0.019) and drain removal (P=0.011) were statistically shorter in LLS.
  
  
  CONCLUSIONS
  LLS is more safe and feasible with shorter hospital stay compared with ALS.
authors.affiliation: General Surgery Department, Oncology Centre of Mansoura University, Gharbya, Egypt.
authors.forename: Adel
authors.initials: A
authors.lastname: Fathi
authors.forename: Osama
authors.initials: O
authors.lastname: Eldamshety
authors.forename: Osama
authors.initials: O
authors.lastname: Bahy
authors.forename: Adel
authors.initials: A
authors.lastname: Denewer
authors.forename: Tamer
authors.initials: T
authors.lastname: Fady
authors.forename: Fayez
authors.initials: F
authors.lastname: Shehatto
authors.forename: Ashraf
authors.initials: A
authors.lastname: Khater
authors.forename: Waleed
authors.initials: W
authors.lastname: Elnahas
authors.forename: Sameh
authors.initials: S
authors.lastname: Roshdy
authors.forename: Omar
authors.initials: O
authors.lastname: Farouk
authors.forename: Ahmed
authors.initials: A
authors.lastname: Senbel
authors.forename: Emad-Eldeen
authors.initials: EE
authors.lastname: Hamed
authors.forename: Ahmed
authors.initials: A
authors.lastname: Setit
mesh_terms: D004534:Egypt / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D013163:Splenomegaly / Q000601:surgery*; D016896:Treatment Outcome