Background: Laparoscopic splenectomy (LS) has been established as a safe and effective alternative to open splenectomy (OS) for the treatment of appropriate patients with hematologic disease. The purpose of this study was to review our teaching institution’s experience with splenectomy for hematologic disease.
Methods: Between 1996 and 2005 a total of 101 consecutive splenectomies were performed for both benign (53) and malignant (48) hematologic diseases by a single surgeon. These cases were reviewed for their post-operative outcomes, with particular attention to surgical approach (LS vs. OS), conversions, and complications
Results: 61% of patients underwent planned LS, with a 79% success rate. Patients with malignant disease were significantly older (p< 0.005), had larger spleens (p< 0.007), (40 cases of splenomegaly), more likely to undergo OS (p< 0.0009, 13 attempted LS, 62% success rate), and had longer length of stay (p< 0.02). However, there was no significant difference in OR time, transfusion requirements, morbidity or mortality rates between patients with benign and malignant disease.
Conclusion: LS is feasible for both benign and malignant hematologic disease. However, LS for spleens larger than 1 kg or 15 cm in greatest diameter is possible, but may not be of significant benefit to the patient.
Program Number: P401