This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Laparoscopic splenectomy: a suitable technique for children and adults. BJS 2000; 87: 362-362.
Published: 6th December 2002
Authors: T. J. Wheatley, J. M. S. Johnstone, G. S. M. Robertson, M. Hutchinson, J. K. Wood, D. M. Lloyd et al.
Method
An operative technique evolved over the 5‐year period from 1994, from an initial six‐port approach with the patient supine, to a four‐port approach in a modified right lateral position, with locking surgical clips applied down a 5‐mm port to vessels in the hilum, and removal of the spleen within a retrieval bag through a 4–6‐cm Pfannanstiel incision. Data were collected prospectively for all patients undergoing laparoscopic splenectomy at Leicester Royal Infirmary, including demographic details, indication for surgery, duration of surgery, length of inpatient stay, transfusion requirement, postoperative complications and the response of the original condition to surgical intervention.
Results
A total of 40 patients underwent laparoscopic splenectomy (14 children, 26 adults) for a variety of conditions (idiopathic thrombocytopenia (ITP) (n = 24), haemolytic anaemia (n = 9) or malignancy (n = 7)) with a median operating time of 180 min for the first 20 patients and 100 min for the second 20 (P < 0·0001), and median inpatient stay of 3 days for the first 20 patients and 2 days for the second 20 (P < 0·0003). None of the operations was converted to open surgery, five patients required blood and/or platelet transfusion perioperatively, none of the patients had major postoperative complications, 23 of the 24 patients with ITP developed normal platelet counts after operation, and all nine patients with haemolytic anaemia maintained a normal haemoglobin concentration after operation.