Related Experiment Video
Updated: Mar 13, 2026
Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions
Published on: December 20, 2024
[Laparoscopic splenectomy in hematologic diseases in children. Analysis of 11-year experience]
E Bracho-Blanchet1, R Dávila-Pérez1, C Zalles-Vidal1
1Departamento de Cirugía General. Hospital Infantil de México Federico Gómez, Secretaría de Salud, México, D.F.
Insights
Laparoscopic splenectomy is a safe and effective procedure for pediatric hematologic diseases, with a low conversion rate. Key risk factors for conversion include significant bleeding and the need for blood transfusions.
Area of Science:
- Pediatric surgery
- Hematology
- Surgical oncology
Background:
- Splenectomy is frequently indicated for pediatric hematologic diseases.
- Laparoscopic splenectomy offers a minimally invasive approach.
Purpose of the Study:
- To evaluate the indications, clinical course, and complications of laparoscopic splenectomy in children.
- To identify factors associated with conversion to open surgery.
Main Methods:
- Retrospective analysis of 88 laparoscopic splenectomies over 11 years.
- Inclusion of long-term follow-up data.
Main Results:
- Hemolytic anemia (77%) and thrombocytopenic purpura (18%) were primary indications.
- Conversion rate was 5.7%, primarily due to bleeding (>300 ml) or transfusion needs.
- Successful treatment outcomes observed in 83.3% of patients.
Conclusions:
- Laparoscopic splenectomy is feasible in young children and those with anemia or thrombocytopenia.
- Bleeding exceeding 300 ml and requiring erythrocyte concentrate transfusion are risk factors for conversion.
Objectives:
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.
Material And 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%.
Discussion:
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.
More Related Videos
04:40Bloodless Laparoscopic Partial Splenectomy Assisted by Bipolar Radiofrequency Excision Hemostatic Device
Published on: November 4, 2022
04:00Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
