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KMID : 0978820060090010001
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2006 Volume.9 No. 1 p.1 ~ p.4
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Comparison of Laparoscopic and Open Splenectomy
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Kim Seong-Yup
Jang Jin-Young
Kim Sun-Whe
Park Yong-Hyun
Han Sung-Sik
Park Yun-Chan
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Abstract
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Purpose: Recently, the indication of the laparoscopic splenectomy is expanding. It was traditionally limited to the patients without splenomegaly, mainly idiopathic thrombocytopenic purpura, however it’s application expanding to even those with splenomegaly such as hereditay spherocytosis, autoimmune hemolytic anemia and malignant hematologic disease. The aim of this study is to compare the clinical results reflected from the patients who underwent laparoscopic splenectomy with those who underwent open splenectomy.
Methods: Between January 1998 to March 2004, consecutive 66 patients were underwent splenectomy in Seoul National University Hospital. Demographic findings and clinical outcomes were compared between the laparoscopic splenectomy (n=33) and open splenectomy (n=33) groups.
Results: The patients who underwent the laparoscopic splenectomy had earlier diet start (3.5?1.5 versus 4.5?1.5 days, p＜0.05) and shorter postoperative hospital stay (7.2?6.3 versus 10.8?3.2 days, p＜0.05) and shorter duration ofpostoperative analgesics injection (1.6?1.1 versus 4.0?2.6 days, p＜0.05 ) than those who underwent open splenectomy. The operative time, estimated blood loss, and complication rate for the two groups were similar. The size of spleen was larger in the group of patients who underwent laparoscopic splenectomy (292.5?255.6 ml) than those who open splenectomy (1,135.4?1,277.9 ml)(p＜0.05 ), but there were some patients who underwent laparoscopic splenectomy with severe splenomegaly (627, 544, 1,264 ml).
Conclusion: The laparoscopic splenectomy has several advantage such as earlier diet start, shorter postoperative hospital stay and less postoperative pain. With the accumulation of laparoscopic surgery cases and advances in instrument, limitation of technique to splenomegaly has been overcome.
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KEYWORD
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Splenectomy, Laparoscopy, Treatment outcome
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