engleski

The experience in laparoscopic splenectomy- complications review with case report.

Results: Majority of patients submitted to LS had benign hematologic disease (31 of 40) and more than half of them had splenomegaly (23/40). Almost all patients with splenic malignancy have splenomegaly (8 of 9). The mean spleen size in splenomegaly patients was 23, 88 cm (range 15-31 cm). Splenomegaly was associated with higher conversion rate (3 vs 2) due tobleeding and longer mean operative time (128, 54 vs 104, 75 min). Furthermore, in splenomegaly more patients (7 vs 1) required accessory incision and additional port and blood transfusion (8 vs 1). But length of stay and postoperative morbidity was not associated with enlarged spleen in our series. The postoperative complications were recorded in 3 patients following the LS (7.5%). Intraoperative lesion of descending colon with prompt laparoscopic suturing was experienced in one patient. The PVT was noted in two patients (5%) ; one without significant clinical signs while the presented one developed severe clinical feature with intestinal ischemia presenting as acute abdomen and submitted to explorative laparotomy. Both were treated conservatively. Both patients had ITP ; the asymptomatic case had splenomegaly, while the presented patient had normal sized spleen. Conclusion: According to our results, the same as to some previously presented studies LS has become a treatment of choice for majority of patients including those with splenomegaly. In spite of longer operative time and more blood loss laparoscopic splenectomy in the setting of splenomegaly is safe in appropriately experienced hands with full awareness of increased complexity of technical performance and caution requirement. The early detection of PVT as expected postoperative complication is essential. The development of PVT was not associated with spleen size in our study

laparoscopic splenectomy

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