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[Laparoscopic splenectomy in congenital hemolytic anemia in children]
Insights
Laparoscopic splenectomy is a safe and effective minimally invasive surgery for children with congenital hemolytic anemia. This procedure offers excellent cosmetic results and a fast recovery, with no reported complications.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hematology
Background:
- Congenital hemolytic anemia necessitates spleen removal (splenectomy) in pediatric patients.
- Traditional open splenectomy carries risks and longer recovery times.
- Laparoscopic techniques offer a less invasive alternative.
Purpose of the Study:
- To analyze the safety and efficacy of laparoscopic splenectomy in children with congenital hemolytic anemia.
- To evaluate the surgical outcomes, complications, and recovery associated with the procedure.
Main Methods:
- Retrospective analysis of 48 laparoscopic splenectomies performed in children aged 3-14 years.
- Detailed description of surgical steps including splenic isolation, ligament transection, vascular control, and organ removal.
- Inclusion of data on concomitant procedures like one-stage cholecystectomy.
Main Results:
- Average surgery time was 110-115 minutes, extended by 30-40 minutes for additional cholecystectomy.
- No intraoperative or postoperative complications were reported.
- Conversion to open surgery occurred in 2 cases due to endostapler issues.
- Patients were discharged between days 5-8, with full recovery of physical activity in 10-14 days.
- No fatalities were observed, and all patients achieved excellent cosmetic outcomes.
Conclusions:
- Laparoscopic splenectomy is a safe, sparing, and effective endoscopic surgical option for children with congenital hemolytic anemia.
- The procedure demonstrates favorable outcomes regarding complications, recovery, and cosmesis.
Abstract:
Experience of 48 laparoscopic splenectomies in children aged from 3 to 14 years with congenital hemolytic anemia is analyzed. The main stages of laparoscopic splenectomy were the following: isolation of the inferior pole of the spleen, transection of the gastro-splenic ligament, transection of the splenic vascular trunk (with endostapler or intracorporeal ligature), dissection of the splenic ligaments, removal of the organ (with endoscopic sac or morcellator). One-stage cholecystectomy for cholelithiasis was performed in 11 patients. Time of surgery was 110-115 minutes, on the average. One-stage cholecystectomy prolonged surgery by 30-40 minutes. There were no intraoperative and postoperative complications. Conversion to open surgery was necessary in 2 cases because of endostapler failure. Patients were discharged on the 5-8th day after surgery. Physical activity restored completely 10-14 days after surgery. There were no lethal outcomes. Excellent cosmetic results were achieved in all the patients. Laparoscopic splenectomy in congenital hemolytic anemia is safe, sparing and effective endoscopic surgery in childhood.