Comparison of perioperative outcomes between laparoscopic and open partial splenectomy in children and adolescents.

Autor:	Makansi M; Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Frankfurt am Main 60590, Germany., Hutter M; Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Frankfurt am Main 60590, Germany., Theilen TM; Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Frankfurt am Main 60590, Germany., Fiegel HC; Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Frankfurt am Main 60590, Germany., Rolle U; Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Frankfurt am Main 60590, Germany., Gfroerer S; Department of Pediatric Surgery and Pediatric Urology, Helios Clinic Berlin-Buch, Berlin 13125, Germany. stefan.gfroerer@helios-gesundheit.de.
Jazyk:	angličtina
Zdroj:	World journal of gastrointestinal surgery [World J Gastrointest Surg] 2021 Sep 27; Vol. 13 (9), pp. 979-987.
DOI:	10.4240/wjgs.v13.i9.979
Abstrakt:	Background: In order to avoid consequences of total splenectomy, partial splenectomy (PS) is increasingly reported. The purpose of this study was to compare perioperative outcomes of laparoscopic PS (LPS) and open PS (OPS) in children and adolescents. Aim: To compare perioperative outcomes of patients with LPS and OPS. Methods: After institutional review board approval, a total of 26 patients that underwent LPS or OPS between January 2008 and July 2018 were identified from the database of our tertiary referral center. In total, 10 patients had LPS, and 16 patients underwent OPS. Blood loss was calculated by Mercuriali's formula. Pain scores, analgesic requirements and complications were assessed. The Wilcoxon rank sum test was used for comparison. To compare categorical variables, Fisher's exact test was applied. Results: LPS was performed in 10 patients; 16 patients had OPS. Demographics (except for body mass index and duration of follow-up), indicating primary disease, preoperative spleen size and postoperative spleen volume, perioperative hematological parameters, postoperative pain scores, analgesic requirements, adverse events according to the Clavien-Dindo classification and the comprehensive complication index, median time from operation to initiation of feeds, median time from operation to full feeds, median time from operation to mobilization and median length of hospital stay did not differ between LPS and OPS. Median (range) operative time (min) was longer in LPS compared to the OPS group [185 (135-298) vs 144 (112-270), respectively; P = 0.048]. Calculated perioperative blood loss (mL of red blood cell count) was higher in the LPS group compared to OPS [87 (-45-777) vs -37 (-114-553), respectively; P = 0.039]. Conclusion: This is the first study that compared outcomes of LPS and OPS. Both operative approaches had comparable perioperative outcomes. LPS appears to be a viable alternative to OPS. Competing Interests: Conflict-of-interest statement: Makansi M, Hutter M and Drs. Gfroerer S, Fiegel HC, Theilen TM and Rolle U have no conflicts of interest or financial ties to disclose in relation to this manuscript. (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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