• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Laparoscopic Splenectomy for Massive Splenomegaly in Older Adults

Jonathan G Bailey, MD, Dennis Klassen, MD, FRCSC

Department of Surgery, Division of General Surgery, Dalhousie University

Introduction: In the United States, the proportion of people over the age of 60 is projected to increase from 18% in 2009 to 27% by 2050. In the setting of massive splenomegaly authors initially raised concerns about laparoscopic splenectomy, however more recent studies have shown positive results in adults. Studies have found that laparoscopic splenectomy in older adults is associated with low rates of morbidity and mortality, but it is unclear if that is true for older adults with massive splenomegaly. The primary objective of this study is to compare rates of complications and mortality between older adult patients (>65 years) with massive splenomegaly versus older adults without massive splenomegaly undergoing laparoscopic splenectomy (conventional or hand assisted).

Methods: Patients (>65 years) undergoing laparoscopic splenectomy (conventional or hand assisted) at a tertiary care center between January 1, 2003 and July 31, 2011 were included. Patients who underwent urgent or emergent splenectomy were excluded. A retrospective chart review was utilized to extract demographic information and postoperative outcomes. Baseline characteristics and clinical outcomes were compared between those patients with and those without massive splenomegaly (defined as a splenic mass of >1000gm as reported by pathology). Independent t-tests were used for continuous data and chi-squared tests for binary and ordinal data.

Results: Fifty eight patients were included for analysis. Mean age, BMI and Charlson comorbidity index (CCI) for the cohort were 74.5 (range 65.0-88.6) years, 27.2 (range 17.0-39.0) kg/m2 and 1.9 (range 0.0-6.0) CCI, respectively. 33 of 58 patients, (56.9%) were male, 53 (91.4%) had at least one comorbidity and 44 (75.9%) had two or more comorbidities. Mean follow up length for the cohort was 858.0 (+/-761.1) days. There were 19 patients with and 39 without massive splenomegaly (>1000gm). Mean splenic mass was 2497.4 (+/-1382.0)gm and 316.5 (+/-286.6)gm for the two groups. There was no statistical difference for baseline characteristics or follow up period between the two groups, except for splenic mass. Patients with massive splenomegaly were more likely to undergo hand assisted splenectomy (94.7%) compared to those without massive splenomegaly (10.3%; p<0.0001). Older adults with massive splenomegaly had longer operative times (172.8+/-33.7 versus 128.0+/-62.9min, p=0.0008) and longer lengths of stay (11.5+/-11.3 versus 3.5+/-3.3 days, p=0.0066). Patients with massive splenomegaly were more likely to be transfused (7(58.3%) versus 5(41.7%), p=0.0390) and to experience a complication (17(89.5%) versus 17(43.6%), p=0.0004). However, only 7(12.1%) patients experienced a major complication, with no statistical difference between groups. The one year mortality rate was higher among patients with massive splenomegaly (4(21.1%) versus 1(2.6%), p=0.0225). There were no conversions to open surgery in either group.

Conclusion: Older adult patients with massive splenomegaly experience longer operative times, longer hospital stays and more complications. Older patients undergoing splenectomy for massive splenomegaly should be made aware of the high rate of morbidity and mortality. However, few major complications occurred and the high one year mortality rate is likely a reflection of the underlying disease process. Additional studies need to examine changes in quality of life after laparoscopic splenectomy in this population.


Session: Poster Presentation

Program Number: P663

96

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2013 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons