Comparative analysis of laparoscopic versus open splenectomy

L. Michael Brunt, Jacob C. Langer, Mary A. Quasebarth, Eric D. Whitman

Research output: Contribution to journalArticle

154 Citations (Scopus)

Abstract

BACKGROUND: Laparoscopic splenectomy (LS) has been used to treat a variety of splenic disorders. However, there have been few direct comparisons of this approach with open splenectomy (OS). METHODS: Results and outcomes were compared retrospectively in 46 consecutive patients treated by laparoscopic (n = 26) or open splenectomy (n = 20) from January 1990 through March 1996. The two groups were similar in age, sex, and American Society of Anesthesiology classification. Splenectomy was performed for a variety of indications, and the majority of patients in both groups had normal or near- normal size spleens. All data are expressed as mean ± standard deviation. RESULTS: Laparoscopic splenectomy was successfully completed in all 26 attempted cases. Operative times were significantly longer for LS (202 ± 55 minutes) than for OS (134 ± 43 minutes) (P < 0.001); however, operative times in the last 13 LS cases (176 ± 48 minutes) averaged 51 minutes less than in the first 13 cases (227 ± 51 minutes). Estimated operative blood loss was less for LS (222 ± 280 mL) than for OS (376 ± 500 mL) (P = not significant). A mean of 2.0 units of red blood cells was transfused in 4 (15%) of 26 patients during LS vs 1.0 unit transfused in 2 (10%) of 20 patients who had OS (P = NS). Patients who underwent LS required significantly less parenteral pain medications, had a more rapid return to regular diet, and were discharged sooner than patients who had OS. Complication rates were similar in the two groups. CONCLUSIONS: These results suggest that LS is technically safe and has several advantages over OS. Laparoscopic splenectomy should become the procedure of choice for the removal of normal and near-normal size spleens.

Original languageEnglish (US)
Pages (from-to)596-601
Number of pages6
JournalAmerican Journal of Surgery
Volume172
Issue number5
DOIs
StatePublished - Nov 1 1996
Externally publishedYes

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Splenectomy
Operative Time
Spleen
Anesthesiology

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Brunt, L. Michael ; Langer, Jacob C. ; Quasebarth, Mary A. ; Whitman, Eric D. / Comparative analysis of laparoscopic versus open splenectomy. In: American Journal of Surgery. 1996 ; Vol. 172, No. 5. pp. 596-601.
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Comparative analysis of laparoscopic versus open splenectomy. / Brunt, L. Michael; Langer, Jacob C.; Quasebarth, Mary A.; Whitman, Eric D.

In: American Journal of Surgery, Vol. 172, No. 5, 01.11.1996, p. 596-601.

Research output: Contribution to journalArticle

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N2 - BACKGROUND: Laparoscopic splenectomy (LS) has been used to treat a variety of splenic disorders. However, there have been few direct comparisons of this approach with open splenectomy (OS). METHODS: Results and outcomes were compared retrospectively in 46 consecutive patients treated by laparoscopic (n = 26) or open splenectomy (n = 20) from January 1990 through March 1996. The two groups were similar in age, sex, and American Society of Anesthesiology classification. Splenectomy was performed for a variety of indications, and the majority of patients in both groups had normal or near- normal size spleens. All data are expressed as mean ± standard deviation. RESULTS: Laparoscopic splenectomy was successfully completed in all 26 attempted cases. Operative times were significantly longer for LS (202 ± 55 minutes) than for OS (134 ± 43 minutes) (P < 0.001); however, operative times in the last 13 LS cases (176 ± 48 minutes) averaged 51 minutes less than in the first 13 cases (227 ± 51 minutes). Estimated operative blood loss was less for LS (222 ± 280 mL) than for OS (376 ± 500 mL) (P = not significant). A mean of 2.0 units of red blood cells was transfused in 4 (15%) of 26 patients during LS vs 1.0 unit transfused in 2 (10%) of 20 patients who had OS (P = NS). Patients who underwent LS required significantly less parenteral pain medications, had a more rapid return to regular diet, and were discharged sooner than patients who had OS. Complication rates were similar in the two groups. CONCLUSIONS: These results suggest that LS is technically safe and has several advantages over OS. Laparoscopic splenectomy should become the procedure of choice for the removal of normal and near-normal size spleens.

AB - BACKGROUND: Laparoscopic splenectomy (LS) has been used to treat a variety of splenic disorders. However, there have been few direct comparisons of this approach with open splenectomy (OS). METHODS: Results and outcomes were compared retrospectively in 46 consecutive patients treated by laparoscopic (n = 26) or open splenectomy (n = 20) from January 1990 through March 1996. The two groups were similar in age, sex, and American Society of Anesthesiology classification. Splenectomy was performed for a variety of indications, and the majority of patients in both groups had normal or near- normal size spleens. All data are expressed as mean ± standard deviation. RESULTS: Laparoscopic splenectomy was successfully completed in all 26 attempted cases. Operative times were significantly longer for LS (202 ± 55 minutes) than for OS (134 ± 43 minutes) (P < 0.001); however, operative times in the last 13 LS cases (176 ± 48 minutes) averaged 51 minutes less than in the first 13 cases (227 ± 51 minutes). Estimated operative blood loss was less for LS (222 ± 280 mL) than for OS (376 ± 500 mL) (P = not significant). A mean of 2.0 units of red blood cells was transfused in 4 (15%) of 26 patients during LS vs 1.0 unit transfused in 2 (10%) of 20 patients who had OS (P = NS). Patients who underwent LS required significantly less parenteral pain medications, had a more rapid return to regular diet, and were discharged sooner than patients who had OS. Complication rates were similar in the two groups. CONCLUSIONS: These results suggest that LS is technically safe and has several advantages over OS. Laparoscopic splenectomy should become the procedure of choice for the removal of normal and near-normal size spleens.

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