The impact of splenic weight on laparoscopic splenectomy for splenomegaly

Surg Endosc. 2002 Jan;16(1):103-7. doi: 10.1007/s00464-001-9045-2. Epub 2001 Oct 5.

Abstract

Background: Enlarged spleens increase the technical difficulties associated with laparoscopic splenectomy (LS). The aim of this study was to analyze the impact of splenic weight on the results of LS.

Methods: We performed a prospective analysis of 20 LS for splenomegaly and 40 LS for normal spleen in terms of intraoperative and early postoperative outcome.

Results: Patients with splenomegaly had longer operative times and higher conversion and transfusion rates than those with normal spleens. Patients with spleens weighing < 2000 G experienced less blood loss, fewer conversions, and a shorter postoperative hospital stay than those with spleens > 2000 g. No differences-except for the longer operative time-were observed between normal-sized spleens and those weighing < 2000 G.

Conclusions: LS for splenomegaly is feasible for experienced laparoscopic surgeons. For spleens weighing < 2000 G, the outcome was comparable to that of normal spleens, whereas LS for spleens >2000 g was associated with a higher conversion rate, greater blood loss, a longer hospital stay, and increased morbidity.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Organ Size / physiology*
  • Prospective Studies
  • Spleen / pathology*
  • Spleen / surgery*
  • Splenectomy / methods*
  • Splenomegaly / surgery*