Hironori Shiozaki, Takeshi Gocho, Keigo Nakashima, Rui Marukuchi, Yoshihiro Shirai, Jungo Yasuda, Kenei Furukawa, Shinji Onda, Hiroaki Shiba, Yuichi Ishida, Katsuhiko Yanaga. The Jikei University School of Medicine
Background: Laparoscopic splenectomy is becoming the standard procedure for benign splenic disorders including hematologic diseases and hypersplenism. However, the feasibility and safety of laparoscopic splenectomy for nodular and cystic splenic lesions are yet to be elucidated.
Methods: Twelve patients with splenic nodular or cystic lesions who underwent laparoscopic splenectomy between April 2003 and June 2018 were retrospectively reviewed, in which patient factors (age, sex), lesion factors (diagnosis, size, number) and surgical factors (procedures, operation time, blood loss, postoperative complication, postoperative hospital stay) were assessed.
Results: The median age was 44.5 (21 to 72) years, and 6 patients (50%) were male. Splenectomy was performed by either pure laparoscopy (n = 3), hand – assisted laparoscopic surgery (HALS) (n = 5) or single incision laparoscopic surgery (SILS) (n = 4), for solid lesions in 8 and cystic lesions in 4 patients. Eleven patients had a single lesion, of which maximum diameter was 50.5 (range, 28 – 100) mm. The operation time was 178.5 (range, 90 – 254) min and intraoperative blood loss was 12.5 (range, 0 – 622) g. Splenectomies were performed without intraoperative or postoperative complications of Grade ?b or more by Clavien-Dindo classification except for 2 cases with postoperative pancreatic fistulas which were Grade A by International study group of postoperative pancreatic fistula (ISGPF). All laparoscopic splenectomies were performed without tumor rupture during the procedure. Final diagnosis was confirmed pathologically as hemangiomas in 3, SANT in 3, inflammatory pseudotumor in 2, malignant lymphoma in one, lymphangioma in one, simple cyst in one and pseudocyst in one patient.
Conclusions: Laparoscopic splenectomy for the nodular and cystic lesion is safe and feasible.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94363
Program Number: P605
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster