Lateral Versus Anterior Approach Laparoscopic Splenectomy: A Randomized-controlled Study
| Autor: | Osama Bahy, Waleed Elnahas, Omar Farouk, Ahmed Setit, Osama Eldamshety, Fayez Shehatto, Ahmed Senbel, Emad-Eldeen Hamed, Adel Fathi, Adel Denewer, Ashraf Khater, Tamer Fady, Sameh Roshdy |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Blood transfusion medicine.medical_treatment Splenectomy Laparoscopic splenectomy law.invention 03 medical and health sciences 0302 clinical medicine Postoperative Complications Randomized controlled trial Blood loss law medicine Humans Retrospective Studies business.industry Incidence (epidemiology) Incidence Retrospective cohort study Length of Stay Middle Aged Surgery Treatment Outcome 030220 oncology & carcinogenesis Splenomegaly Feasibility Studies 030211 gastroenterology & hepatology Egypt Female Laparoscopy Anterior approach business |
| Zdroj: | Surgical laparoscopy, endoscopypercutaneous techniques. 26(6) |
| ISSN: | 1534-4908 |
| Popis: | The study compares prospectively the hospital stay and postoperative complications of anterior (ALS) versus lateral (LLS) approach for laparoscopic splenectomy.Between September 2011 and April 2015, 94 patients with splenomegaly were referred to the surgical unit in the Oncology Center of Mansoura University, Egypt. Only 80 patients with splenomegaly30 cm underwent an open-label randomized allocation into 2 equal parallel groups. Indications were hematological in 52 patients (65%) and malignant splenic conditions in 28 patients (35%). Two patients younger than 18 years, 4 patients with splenomegaly30 cm, and 8 patients with associated surgical comorbidities were excluded. Three days' hospital stay reduction with LLS was suggested with a power of 80% and P-value of 0.05.The mean hospital stay was significantly shorter (P=0.001) after LLS. Laparoscopic splenectomy was completed in 68 patients (85%). Twelve patients (15%) required open splenectomy with no difference between groups. The operation time was significantly shorter in LLS (P=0.013). Blood loss (P=0.057) and blood transfusion (P=0.376) showed no difference between the two groups. The times until resumption of oral intake (P=0.019) and drain removal (P=0.011) were statistically shorter in LLS.LLS is more safe and feasible with shorter hospital stay compared with ALS. |
| Databáze: | OpenAIRE |
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