Prognostic scoring system of laparoscopic splenectomy in children with benign hematological diseases, a retrospective cohort study

Abstract

Purpose laparoscopic splenectomy (LS) gained popularity during the last years among pediatric surgeons. Benign hematological diseases represent the main indications of that procedure. There are some score systems of difficulty of the technique. Most of them are for adult patients. The aim is to develop a prognostic score system of LS in children with benign hematological diseases. Methods LS was performed in all children with benign hematological diseases. The children were operated in lateral decubitus position. The control of pedicle was achieved using bipolar sealing devices, polymer clips or endoscopic linear stablers. Preoperative, operative, and postoperative data were recorded and analyzed. Children were divided into two groups A and B according to the onset of complications. Results 137 successive children were operated. The mean age of patients was 8.7 (4–15) years. The main indications of LS were thalassemia, spherocytosis, idiopathic thrombocytopenic purpura (ITP), and sickle cell anemia (SCA). The mean length of splenic axis in thalassemia and spherocytosis cases was15.6 ± 2.3 cm. The mean amount of estimated blood loss (EABL) was 149 ± 43.2 ml in group A while it was 185 ± 44.4 ml in group B. The mean operative time in group A was 75.5 ± 22.5 min while it was 89.2 ± 20.6 min in group B. Conclusion the development of prognostic score of LS in children with benign hematological diseases can predict children who are more susceptible for complications. It helps to minimize these complications and improve the outcome of LS.