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Massive splenomegaly in children: laparoscopic versus open splenectomy
Mohamed E Hassan1, Khalid Al Ali2
1Pediatric Surgery Unit, General Surgery Department, Zagazig University, Zagazig, Egypt.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|November 14, 2014
Summary
Laparoscopic splenectomy in children with massive splenomegaly is safe and feasible. This approach offers reduced pain, blood loss, and shorter hospital stays compared to open surgery.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hematologic Disorders
Background:
- Massive splenomegaly in children presents surgical challenges.
- Laparoscopic splenectomy (LS) versus open splenectomy (OS) for massive splenomegaly is debated.
Purpose of the Study:
- To compare the feasibility of LS versus OS for massive splenomegaly in children.
- To evaluate surgical outcomes from different aspects.
Main Methods:
- Retrospective review of 32 children (<12 years) with massive splenomegaly undergoing splenectomy for hematologic disorders.
- Data collected from two pediatric surgery centers (June 2004 - July 2012).
Main Results:
- LS group (12 patients) had longer operative time (180 min) vs OS group (20 patients, 120 min).
- LS showed significantly less blood loss (60 mL vs 110 mL), reduced postoperative pain, and faster oral feeding (7.5 hrs vs 30 hrs).
- LS resulted in a shorter hospital stay (36 hrs vs 96 hrs) with similar complication rates (e.g., atelectasis).
Conclusions:
- Laparoscopic splenectomy is a safe and feasible option for pediatric massive splenomegaly.
- LS offers significant advantages in recovery, pain management, and hospital stay.
- LS should be considered the gold-standard approach for pediatric hematologic disorders requiring splenectomy.
