Laparoscopic Splenectomy for Splenomegaly

Targarona, E. M.; Balagu, Carmen; as, Manuel Tr

doi:10.1097/00013452-200209000-00010

Cited by 6 publications

(10 citation statements)

References 16 publications

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“…Several reports of open splenectomy for hematological malignancies and splenomegaly have documented complication rates of 30-52% and mortality rates of 11% [7,10,23]. Increased morbidity and mortality have been noted mainly after open splenectomy for myeloproliferative disorders, lymphoproliferative disorders, and nonHodgkin's lymphoma compared with Hodgkin's disease.…”

Section: Discussionmentioning

confidence: 99%

“…The main reason for conversion in our malignant group was spleen size, due to the impossibility of handling [23,24]. New devices for hand-assisted laparoscopic surgery (HALS) have become available, and this technique can be especially useful in cases of LS for splenomegaly or malignancy [22,26].…”

Section: Discussionmentioning

confidence: 99%

“…In our series, HALS was used in 34 patients (13% of all patients); in 27 it was used for malignant diseases (41% of patients diagnosed with malignancy). Currently, hand-assisted laparoscopic splenectomy is performed in cases of spleens weighing more than 1000 g, with satisfactory results, but further studies with larger series are required [23].…”

Section: Discussionmentioning

confidence: 99%

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Long-term outcome after laparoscopic splenectomy related to hematologic diagnosis

et al. 2004

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Long-term outcome after laparoscopic splenectomy related to hematologic diagnosis

et al. 2004

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“…Başlangıçta her ne kadar splenomegali laparoskopik splenektomi için kontrendike olarak kabul edilmiş olsa da, uygun malzemelerin üretimi, gelişen teknoloji ve iyi teknik yaklaşımla bu problem çözülmüştür (7,8,9) . Ancak Targarona ve ark.nın son yayınlarında el yardımlı laparoskopik splenektominin laparoskopik splenektomiye göre komplikasyon oranlarını ve ameliyat süresini azalttığı belirtilmektedir (4,10).…”

Section: Discussionunclassified

“…geç dönemde herhangi bir komplikasyon gelişmedi (2,4). Kozmetik olarak sonuç, hem çocuk hem de ailesi için oldukça tatmin ediciydi.…”

Section: Journal Of Ankara University Faculty Of Medicine 2005; 58(4)unclassified

Büyük dalağı olan çocuk hastalarda da laparoskopik splenektomi yapılabilir: Bir olgu sunumu Laparoscopic splenectomy can be performed in pediatric patien ts with h uge spleen: A case report

Vargun¹

2005

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Herediter Sferositoz nedeniyle splenektomi endikasyonu konulan 13 yaşındaki erkek çocuğun yapılan ultrasonografik ve manyetik rezonans görüntüleme incelemelerinde, dalağın 16.5x7x6.5 cm boyutlarında olduğu saptandı. Dört trokar kullanılarak yapılan laparoskopik splenektomide, dalağın karın dışına çıkarılması sırasında, sol alt kadrandaki 12 mm'lik trokar giriş yeri 1.5 cm'ye büyütülerek, derinliği 20 cm genişliği 10 cm olan mekanik olarak daha dayanıklı çıkartıcı torba karın içine ilerletildi. Torba içine alınan dalak, parmakla parçalanarak çıkartıldı. Eş zamanlı olarak safra kesesindeki taşlar nedeniyle laparoskopik kolesistektomi de yapıldı. Laparoskopik splenektomi, büyük dalaklarda bile uygun malzeme seçimi ve iyi teknik yaklaşımla güvenli olarak yapılabilmektedir.Anahtar sözcükler: Laparoskopi, splenektomi, çocuk, splenomegali, herediter sferositoz Splenectomy was planned in a 13 years-old boy with hereditary spherocytosis. Ultrasonography and Magnetic Resonance Imaging revealed a 16.5x7x6.5 cm. sized spleen. During the extripation of the spleen, 12 mm. trocar site in left lower quadrant was extented up to 1.5 cm. A mechanically stronger endobag with a depth of 20 cm., and a width of 10 cm. was inserted. It was morcellated using fingers and then extripated. Laparoscopic cholecystectomy was performed concomitantly for cholelithiasis. Even in vigorous splenomegaly, laparoscopic splenectomy can safely be performed with proper equipment usage and good technical approach.

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Hand-Assisted Laparoscopic Surgery

Targarona

Gracia²,

Rodrı́guez³

et al. 2003

Arch Surg

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Hand-assisted laparoscopic surgery (HALS) has been proposed as a useful alternative to conventional open or laparoscopic surgery. However, most information is fragmented and comes from specific or selective indications. To assess the current situation of HALS, a general overview of the fields of application, results, and quality of the evidence of these results is necessary. Data Sources: Current English-language literature review. Study Selection: Case reports, series, and opinion articles on HALS. Data Extraction and Synthesis: Evaluation of the type of study and results. Most of the articles are short case series. Only a few comparative or randomized comparative trials on HALS for splenectomy and colectomy have been published. Conclusions: Hand-assisted laparoscopic surgery seems to be a promising technique that has been applied with success in a wide range of digestive tract-related surgical procedures. The main role is to help in difficult cases before conversion is necessary or for training unskilled surgeons, and not as an alternative to pure laparoscopic surgery. However, not enough evidence-based data are available to know exactly the final outcome of this technique in general surgery. Prospective randomized trials with established open or laparoscopic procedures are lacking, and these trials are needed to support the final role of HALS.

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Laparoscopic Splenectomy for Splenomegaly

Cited by 6 publications

References 16 publications

Long-term outcome after laparoscopic splenectomy related to hematologic diagnosis

Long-term outcome after laparoscopic splenectomy related to hematologic diagnosis

Büyük dalağı olan çocuk hastalarda da laparoskopik splenektomi yapılabilir: Bir olgu sunumu Laparoscopic splenectomy can be performed in pediatric patien ts with h uge spleen: A case report

Hand-Assisted Laparoscopic Surgery

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