Laparoscopic Splenectomy in Children

Abstract

ABSTRACT

Splenectomy is often indicated for a variety of hematologic disorders. We sought to assess the feasibility of a laparoscopic approach to splenectomy in children and to compare this technique to the standard open approach. Twelve patients, ages 3 to 11 years, underwent an attempted laparoscopic splenectomy during the past 2 years. The indications for splenectomy included sickle cell anemia (6), immune thrombocytopenic purpura (ITP) (4), and B-thalassemia (BT) (2). Ten (83%) splenectomies were completed laparoscopically. Data were also collected for nine open splenectomies performed during the previous year. The mean operative time for the laparoscopic procedures was 150 min as compared to 91 min for the open procedures. The last five laparoscopic procedures were performed in a mean time of 122 min, however. The length of postoperative stay ranged from 2 to 9 days (mean = 4.6 days) for the laparoscopic procedures and from 4 to 9 days (mean = 6.2 days) for the open procedures. Patients undergoing laparoscopic splenectomy for BT or ITP had a mean postoperative stay of 3.5 days. No significant intra- or postoperative complications occurred with either approach. From this experience we conclude that although an advanced procedure, laparoscopic splenectomy can be successfully accomplished in children. The benefits of the laparoscopic approach include improved cosmesis and a shorter length of stay, although patients with certain underlying diseases may be more amenable to early discharge than others.