Limits in Laparoscopic Partial Splenectomy in Children
The aim of this paper is to assess the effectiveness and perioperative complications of splenic surgeries in children. In 41 splenectomies, an anterior abdominal laparoscopic approach was used, with 35 including a partial laparoscopic splenectomy. Of these, three needed a conversion to open. Six pat...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-04-01
|
| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/9/5/605 |
| _version_ | 1827669671272251392 |
|---|---|
| author | Christian Tomuschat Michail Aftzoglou Johanna Hagens Michael Boettcher Konrad Reinshagen |
| author_facet | Christian Tomuschat Michail Aftzoglou Johanna Hagens Michael Boettcher Konrad Reinshagen |
| author_sort | Christian Tomuschat |
| collection | DOAJ |
| description | The aim of this paper is to assess the effectiveness and perioperative complications of splenic surgeries in children. In 41 splenectomies, an anterior abdominal laparoscopic approach was used, with 35 including a partial laparoscopic splenectomy. Of these, three needed a conversion to open. Six patients had a total splenectomy, three of which were open. Patients ranged in age from 5 to 18 years. Splenectomy was performed for a variety of causes, including hereditary spherocytosis (<i>n</i> = 20), splenic cysts (<i>n</i> = 13), sickle cell disease (<i>n</i> = 3), primary malignancy (<i>n</i> = 1), sepsis (<i>n</i> = 1), embolism (<i>n</i> = 1), anemia (<i>n</i> = 1), and hypersplenism (<i>n</i> = 1). The average length of stay was 7.6 days, and the average operation time was 169.3 min. Pleural effusion in the left hemithorax was found in 31.6% of the patients, with 5.3% requiring a thorax drain. The majority of patients had the highest platelet count two weeks after surgery. There was no evidence of wound infection, pancreatic leak, colon perforation, or postoperative sepsis. The most encountered perioperative complication was bleeding with the need of transfusion (<i>n</i> = 6), and one patient needed a diaphragm repair. A partial splenectomy (PS) can be a difficult procedure with a steep learning curve. For most children who require a splenic operation, this should be the primary procedure of choice. |
| first_indexed | 2024-03-10T03:09:23Z |
| format | Article |
| id | doaj.art-1e866836efce491fb7ee3a58e89d8897 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T03:09:23Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-1e866836efce491fb7ee3a58e89d88972023-11-23T10:29:44ZengMDPI AGChildren2227-90672022-04-019560510.3390/children9050605Limits in Laparoscopic Partial Splenectomy in ChildrenChristian Tomuschat0Michail Aftzoglou1Johanna Hagens2Michael Boettcher3Konrad Reinshagen4Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, GermanyDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, GermanyDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, GermanyDepartment of Paediatric Surgery, Mannheim University Medical Center (UMM), 68167 Mannheim, GermanyDepartment of Pediatric Surgery, University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, GermanyThe aim of this paper is to assess the effectiveness and perioperative complications of splenic surgeries in children. In 41 splenectomies, an anterior abdominal laparoscopic approach was used, with 35 including a partial laparoscopic splenectomy. Of these, three needed a conversion to open. Six patients had a total splenectomy, three of which were open. Patients ranged in age from 5 to 18 years. Splenectomy was performed for a variety of causes, including hereditary spherocytosis (<i>n</i> = 20), splenic cysts (<i>n</i> = 13), sickle cell disease (<i>n</i> = 3), primary malignancy (<i>n</i> = 1), sepsis (<i>n</i> = 1), embolism (<i>n</i> = 1), anemia (<i>n</i> = 1), and hypersplenism (<i>n</i> = 1). The average length of stay was 7.6 days, and the average operation time was 169.3 min. Pleural effusion in the left hemithorax was found in 31.6% of the patients, with 5.3% requiring a thorax drain. The majority of patients had the highest platelet count two weeks after surgery. There was no evidence of wound infection, pancreatic leak, colon perforation, or postoperative sepsis. The most encountered perioperative complication was bleeding with the need of transfusion (<i>n</i> = 6), and one patient needed a diaphragm repair. A partial splenectomy (PS) can be a difficult procedure with a steep learning curve. For most children who require a splenic operation, this should be the primary procedure of choice.https://www.mdpi.com/2227-9067/9/5/605laparoscopic splenectomypartial splenectomyhereditary spherocytosissplenic cysts |
| spellingShingle | Christian Tomuschat Michail Aftzoglou Johanna Hagens Michael Boettcher Konrad Reinshagen Limits in Laparoscopic Partial Splenectomy in Children Children laparoscopic splenectomy partial splenectomy hereditary spherocytosis splenic cysts |
| title | Limits in Laparoscopic Partial Splenectomy in Children |
| title_full | Limits in Laparoscopic Partial Splenectomy in Children |
| title_fullStr | Limits in Laparoscopic Partial Splenectomy in Children |
| title_full_unstemmed | Limits in Laparoscopic Partial Splenectomy in Children |
| title_short | Limits in Laparoscopic Partial Splenectomy in Children |
| title_sort | limits in laparoscopic partial splenectomy in children |
| topic | laparoscopic splenectomy partial splenectomy hereditary spherocytosis splenic cysts |
| url | https://www.mdpi.com/2227-9067/9/5/605 |
| work_keys_str_mv | AT christiantomuschat limitsinlaparoscopicpartialsplenectomyinchildren AT michailaftzoglou limitsinlaparoscopicpartialsplenectomyinchildren AT johannahagens limitsinlaparoscopicpartialsplenectomyinchildren AT michaelboettcher limitsinlaparoscopicpartialsplenectomyinchildren AT konradreinshagen limitsinlaparoscopicpartialsplenectomyinchildren |