Laparoscopic splenectomy for benign and malignant hematologic diseases: 35 consecutive cases

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Hematology

Background:

• Laparoscopic splenectomy (LS) is established for specific spleen conditions.
• Immune thrombocytopenic purpura is a common indication for LS.
• Limited data exist comparing laparoscopic versus conventional splenectomy for various hematologic disorders.

Purpose of the Study:

• To evaluate the feasibility and safety of laparoscopic splenectomy (LS) for benign and malignant hematologic disorders.
• To compare outcomes of LS in patients with benign versus malignant hematologic conditions.
• To assess the efficacy of LS against conventional splenectomy in literature.

Main Methods:

• Retrospective analysis of 35 laparoscopic splenectomy cases.
• Inclusion of patients with benign (22) and malignant (13) hematologic disorders.
• LS was performed regardless of spleen size.

Main Results:

• Overall operative mortality was 2.9%, with a 23% complication rate.
• Conversion to laparotomy occurred in 9% of cases; accessory spleens were identified in 17%.
• Patients with malignant disease had larger spleens and higher operative risks but similar mortality, complication rates, and hospital stays compared to benign disease patients.

Conclusions:

• Laparoscopic splenectomy demonstrates comparable safety and efficacy for both benign and malignant hematologic conditions.
• LS outcomes appear favorable when compared to conventional splenectomy for similar indications.
• Despite limited experience, LS shows promise as a beneficial surgical approach for a wide range of hematologic disorders.