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KMID : 0978820060090020056
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2006 Volume.9 No. 2 p.56 ~ p.60
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A Comparison of Hand-assisted Laparoscopic versus Open Splenectomy
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Ryu Sung-Mock
Choi Chang-Soo
Kim Woon-Won
Kim Kwang-Hee
Choi Young-Kil
Lee Dong-Woo
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Abstract
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Purpose: To evaluate the feasibility and potential benefits of hand-assisted laparoscopic splenectomy, we compared the perioperative parameters and outcomes achieved with hand-assisted laparoscopic splenectomy (HALS) versus open splenectomy (OS).
Methods: Retrospective data collected from 30 cases of OS performed from 1993 to 2000 and 30 cases of HALS performed from 2001 to 2004 were reviewed. Patient demographics, surgical indications, perioperative results, morbidity, mortality and clinical outcomes were evaluated.
Results: There were no significant differences in age, gender, disease pattern, co-morbidity or previous abdominal surgery history. The average operation time was significantly shorter in patients who underwent HALS versus OS (p=0.008, 73.8?19.4 vs. 90.6?27.3). Operative blood loss was significantly lower for patients who underwent HALS versus OS (p=0.006, 234.1?175.4 vs. 413.3?292.1). Patients who underwent HALS had statistically significant shorter time to oral intake compared with those who underwent OS (p=0.003, 3.0?1.0 vs. 3.8?1.1). HALS patients also required analgesic for a significantly shorter period (p=0.012, 3.1?0.9 vs. 3.9?1.3 days). There were no significant differences in operative transfusion, accessory spleen, postoperative complications and the time from operation to discharge.
Conclusion: HALS had beneficial effects on operation time, blood loss, time to oral intake and duration of analgesic requirements when compared with OS. HALS is a safe procedure and produces better therapeutic results in terms of perioperative parameters than OS. HALS may be accepted as an alternative method to exclusively laparoscopic splenectomy.
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KEYWORD
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Hand-assisted laparoscopic splenectomy, Laparoscopic splenectomy, Splenic disease
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